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Murakami D, Oura H, Yamato M, Nishino T, Arai M. The role of clear visibility in underwater endoscopic submucosal dissection for preventing post-endoscopic submucosal dissection electrocoagulation syndrome. J Gastroenterol Hepatol 2023; 38:2040-2041. [PMID: 37697648 DOI: 10.1111/jgh.16352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 08/26/2023] [Indexed: 09/13/2023]
Affiliation(s)
- D Murakami
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
| | - H Oura
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - M Yamato
- Institute of Advanced Biomedical Engineering and Science, Tokyo Women's Medical University, Tokyo, Japan
| | - T Nishino
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - M Arai
- Department of Gastroenterology, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
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2
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Ishiki Y, Takiguchi T, Kim S, Arai M, Ishii H, Hagiwara J, Hagiwara O, Ogasawara T, Teraoka S, Ogawa F, Yokobori S. Delayed stomach necrosis in a patient with injured celiac artery branches after penetrating abdominal trauma. Trauma Case Rep 2023; 47:100904. [PMID: 37608874 PMCID: PMC10440351 DOI: 10.1016/j.tcr.2023.100904] [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] [Accepted: 08/12/2023] [Indexed: 08/24/2023] Open
Abstract
Injuries of the celiac artery and its branches are rare, but potentially lethal. Ligation of these arteries is performed to control significant hemorrhage. However, few reports have described the adverse effects of ligating these arteries. A 69-year-old woman with a self-inflicted stab wound was brought to our hospital. Her blood pressure could not be measured, therefore aortic cross-clamping was performed, and epinephrine was administered for resuscitation, an emergency laparotomy was performed, and the roots of splenic artery and common hepatic artery were ligated. The left gastric artery which was anomalous and arose directly from the aorta, was also injured and had to be ligated. Norepinephrine was required after the surgery. Enhanced computed tomography performed on hospital day 4 revealed a disrupted celiac artery. The patient developed gastric necrosis on hospital day 23 and, hence, underwent total gastrectomy was performed. The possibility of delayed stomach necrosis should be considered during the postoperative management of patients who undergo ligation of all of the celiac artery branches and experience global hypoperfusion after the surgery.
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Affiliation(s)
- Yoshito Ishiki
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
- Department of Emergency and Critical Care Medicine, Kawaguchi Municipal Hospital, Saitama, Japan
| | - Toru Takiguchi
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
- Department of Emergency and Critical Care Medicine, Kawaguchi Municipal Hospital, Saitama, Japan
| | - Shiei Kim
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Masatoku Arai
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Hiromoto Ishii
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Jun Hagiwara
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Osahiko Hagiwara
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
- Department of Surgery, Toho University Ohashi Medical Center, Tokyo, Japan
| | - Tomoko Ogasawara
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Shintaro Teraoka
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
| | - Futoshi Ogawa
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
- Department of Emergency and Critical Care Medicine, Kawaguchi Municipal Hospital, Saitama, Japan
| | - Shoji Yokobori
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan
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Morizawa Y, Satoh H, Arai M, Iwasa S, Sato A, Fujimoto K. Association Between Nonadherence and Transient Hyperuricemia in Pediatric Kidney Transplantation. Transplant Proc 2023; 55:129-133. [PMID: 36581508 DOI: 10.1016/j.transproceed.2022.09.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 08/29/2022] [Accepted: 09/20/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Nonadherence among pediatric transplant recipients is a significant problem that reduces graft survival and leads to poor kidney graft outcomes. It is, however, extremely difficult to detect during a regular follow-up. This study, therefore, aimed to investigate the risk factors involved in nonadherence, focusing on unexplained transient hyperuricemia in pediatric kidney transplant (KTx) recipients at a single pediatric center. METHODS This retrospective study included 167 patients who underwent KTx at our pediatric center. A Cox proportional hazards analysis was performed to evaluate the risk of nonadherence using the following factors: age, sex, body mass index SD score, transient hyperuricemia, hypertension, and follow-up period. RESULTS Nonadherence was identified in 19 patients (11%), with the average (SD) age and post-KTx duration at diagnosis being 17.21 (4.73) years and 79.21 (38.77) months, respectively. Thirty-four patients (20%) were diagnosed with transient hyperuricemia at a median of 14 months after KTx. On multivariate Cox regression analysis, transient hyperuricemia was the only independent risk factor for nonadherence after KTx. CONCLUSIONS Transient hyperuricemia was identified as one of the risk factors for nonadherence after KTx; therefore, careful monitoring for transient hyperuricemia may allow early detection of nonadherence.
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Affiliation(s)
- Y Morizawa
- Department of Urology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan; Department of Urology, Nara Medical University, Kashihara, Nara, Japan.
| | - H Satoh
- Department of Urology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - M Arai
- Department of Urology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - S Iwasa
- Department of Urology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - A Sato
- Department of Urology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - K Fujimoto
- Department of Urology, Nara Medical University, Kashihara, Nara, Japan
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Takiguchi T, Arai M, Kim S, Ishii H, Ogasawara T, Shigeta K, Mizobuchi T, Yokobori S. Nonocclusive mesenteric ischemia associated with a hyperosmolar hyperglycemic state: Hepatic portal venous gas as an indicator of mesenteric ischemia. Acute Med Surg 2021; 8:e673. [PMID: 34221411 PMCID: PMC8243755 DOI: 10.1002/ams2.673] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 05/12/2021] [Accepted: 06/02/2021] [Indexed: 11/18/2022] Open
Abstract
Background The diagnosis of nonocclusive mesenteric ischemia (NOMI) is always challenging in critically ill patients. Herein, we aimed to report a case of NOMI associated with a hyperosmolar hyperglycemic state (HHS). A small amount of hepatic portal venous gas (HPVG) triggered the diagnosis of NOMI. Case Presentation A 77‐year‐old man was transferred due to shock and disorder of consciousness. He was diagnosed with an HHS. We suspected intestinal ischemia due to a small amount of HPVG revealed by computed tomography (CT). Peritoneal signs were revealed after treatment for the HHS. Computed tomography was carried out again 5 h after admission, which showed a large amount of HPVG, remarkable bowel dilatation, and pneumatosis intestinalis. We performed an emergency laparotomy and resected the small bowel necrosis resulting from NOMI. Conclusion An HHS can cause NOMI, and the presence of HPVG on CT is an important finding that suggests mesenteric ischemia, even in small amounts.
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Affiliation(s)
- Toru Takiguchi
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
| | - Masatoku Arai
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
| | - Shiei Kim
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
| | - Hiromoto Ishii
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
| | - Tomoko Ogasawara
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
| | - Kenta Shigeta
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
| | - Taiki Mizobuchi
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
| | - Shoji Yokobori
- Department of Emergency and Critical Care Medicine Nippon Medical School Tokyo Japan
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Okumura Y, Arai M, Otsuka N, Nagashima K, Watanabe R, Wakamatsu Y, Yagyu S, Nakai T, Hao H, Takahashi R, Taniguchi Y. Influence of obesity and epicardial fat on the progression of electrical and structural remodeling in a canine obese rapid atrial pacing model. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0477] [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
Metabolic syndrome is a cluster of conditions including obesity, insulin resistance, hypertension, and abnormal cholesterol, which increases the cardiovascular risk. Metabolic syndrome or obesity has been reported to provide systemic inflammation and oxidative stress. Increased epicardial fat volume is a manifestation of obesity or metabolic syndrome. Those systemic and local conditions related to obesity or metabolic syndrome have been linking to the risk of atrial fibrillation (AF). The underlying mechanisms of obesity linking epicardial fat to AF progression have not been fully examined.
Purpose
To investigate the impact of obesity linked to epicardial fat on electrophysiologic and anatomical AF substrates.
Methods
Twenty dogs aged 3 years were divided into four groups (n=5 per each): normal diet for over 20 weeks (control group [median body weight: 12.0 kg]), rapid atrial pacing (RAP) for last 4–15 (median 8) weeks during a normal diet for the same period (RAP group [10.5 kg]), high-fat diet (HFD) maintained for over 20 weeks without RAP (MetS group [16.0 kg]), and RAP for last 4–12 (median 6) weeks during HFD maintained for 24 weeks (MetS-RAP group [17.0 kg]), respectively. Activation/voltage maps of the atria during sinus rhythm were created with Ensite NavX mapping system. The effective refractory period (ERP) at 5 left atrial (LA) and pulmonary vein (PV) sites (LA appendage [LAA], LA body, right and left superior PVs, and inferior PV), and AF inducibility by burst LAA pacing were determined. At study completion, hearts were excised for histopathological and gene expression analyses.
Results
The LA pressure was more significantly increased in MetS than the MetS-RAP, RAP, and control groups (22.5 [17–28.8] mmHg vs. 14.0 [10.5–16.3] mmHg, 10.5 [7.4–17.2] mmHg and 10.7 [9.6–13.5] mmHg, respectively, P<0.05). The LA/PV ERP at a basic cycle length of 400 ms was shorter in the MetS-RAP and RAP than MetS and control groups (118±39 ms and 122±44 ms vs. 136±18 ms and 155±39 ms, respectively, P<0.05). Short duration AF was more induced in the MetS and MetS-RAP than RAP and control groups (3 [0–5.5] sec and 2 [0.5–3.5] sec vs. 0 [0–4.5] sec and 0 [0–0] sec, P<0.05). Histological examinations showed the fatty infiltration extending from epicardial fat increased more in the Mets and Mets-RAP than RAP and control groups (Figure). The Fibronectin 1 and collagen I/III mRNA levels increased more in the MetS-RAP and AF than MetS and control groups.
Conclusions
AF vulnerability was associated with increased LA pressures and fibrofatty infiltration from epicardial fat in the MetS group, and with fibrofatty infiltration from epicardial fat with subtle fibrosis in the MetS-RAP group. This suggested that fibrofatty infiltration and epicardial fat plays an important role in AF pathogenesis in obese patients.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): Grant-in-Aid for Scientific Research (KAKENHI)
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Affiliation(s)
- Y Okumura
- Division of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - M Arai
- Division of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - N Otsuka
- Division of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - K Nagashima
- Division of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - R Watanabe
- Division of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - Y Wakamatsu
- Division of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - S Yagyu
- Division of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - T Nakai
- Division of Cardiology, Nihon University School of Medicine, Tokyo, Japan
| | - H Hao
- Nihon University School of Medicine, Department of Pathology and Microbiology, Tokyo, Japan
| | - R Takahashi
- Nihon University School of Medicine, Medical Research Support Center, Section of Laboratory for Animal Experiments, Tokyo, Japan
| | - Y Taniguchi
- Nihon University School of Medicine, Medical Research Support Center, Section of Laboratory for Animal Experiments, Tokyo, Japan
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Arai M, Kim S, Ishii H, Takiguchi T, Yokota H. Portal Venous Gas in Adults: Clinical Significance, Management, and Outcomes of 25 Consecutive Patients. J NIPPON MED SCH 2020; 88:88-96. [PMID: 32238741 DOI: 10.1272/jnms.jnms.2021_88-201] [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: 11/19/2022]
Abstract
BACKGROUND Portal venous gas (PVG) is a rare finding and has a grave prognosis. The most common and critical underlying pathology of PVG is bowel necrosis. However, bowel necrosis is sometimes difficult to accurately diagnose. We retrospectively analyzed data from patients that contributed to the decision to perform emergency surgery and bowel resection. METHODS Between 2009 and 2019, 25 consecutive adult patients with PVG were identified retrospectively and divided into the Operation and Non-operation groups. The Operation group was further subdivided into the Bowel resection and Non-resection groups. Clinical, laboratory, and radiographic variables were analyzed. RESULTS Conservative management was successful for 32% (8/25) of patients (Non-operation group: mortality 0%); 68% (17/25) were treated surgically (Operation group: mortality 35.3%). In the Operation group, 52.9% (9/17) underwent bowel resection (Bowel resection group: mortality 55.6%); however, bowel resection was unnecessary in 47.1% (8/17) of cases (Non-resection group: mortality 12.5%). Univariate analysis revealed significant differences between the Operation and Non-operation groups in GCS, APACHE II, abdominal distention, CRP, lactate, and CT findings of bowel dilatation, pneumatosis intestinalis, and attenuation of contrast effects of the bowel wall. However, with the exception of GCS, there was no significant difference between the Bowel resection and Non-resection groups. CONCLUSIONS Analysis of clinical, laboratory, and radiographic variables can inform decisions on conservative management. However, 47.1% of the present patients who underwent surgery for suspected bowel necrosis did not require bowel resection, suggesting that this approach alone may not be sufficient to avoid non-therapeutic laparotomy. A new approach should be developed to improve this situation.
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Affiliation(s)
- Masatoku Arai
- Department of Emergency & Critical Care Medicine, Nippon Medical School
| | - Shiei Kim
- Department of Emergency & Critical Care Medicine, Nippon Medical School
| | - Hiromoto Ishii
- Department of Emergency & Critical Care Medicine, Nippon Medical School
| | - Toru Takiguchi
- Department of Emergency & Critical Care Medicine, Nippon Medical School
| | - Hiroyuki Yokota
- Department of Emergency & Critical Care Medicine, Nippon Medical School
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Yoshizane T, Tanaka R, Kawasaki M, Otsuka M, Shoji T, Nagaya M, Hattori K, Yagasaki H, Minatoguchi S, Ono K, Murata I, Deguchi T, Arai M, Noda T, Okura H. P4384Noninvasive and novel method to evaluate left ventricular contractility using pressure-volume loop area obtained by 3-dimensional speckle tracking echocardiography. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0789] [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 (LV) pressure-volume (P-V) loop area reflects stroke work (SW), but clinical use of this index is limited by the need of invasive pressure measurement. A noninvasive method to obtain LV pressure-strain loop was recently introduced to assess myocardial work (MW). The minimum LV diastolic pressure (mLVP) was reported to have a strong correlation with Tau and we reported that Tau was noninvasively evaluated by speckle tracking echocardiography (STE).
Purpose
We sought to evaluate the impact of preload change by leg lifts on LV SW noninvasively obtained by the novel method and to examine the utility to assess LV contractility by SW and end-diastolic (ED) volume relation (SW-VED).
Methods
Thirty six controls (age 71±10) and 30 patients with heart failure with reduced ejection fraction (EF) <50% (HF) (age 73±6) were enrolled. LV pressure in a cardiac cycle was estimated using systolic blood pressure (SBP), minimum diastolic pressure (mDP) and ED pressure (EDP) by utilizing the profile of an empiric, normalized reference curve. The mDP and EDP were estimated as (Tau − 33.7)/2.06 and as 12.3 − 10.1 x Log (left atrial active emptying function/minimum volume) as we reported. LVSW was obtained by P-V loop by the combination of these pressures and LV volume using 3-D STE.
Results
LVEF and longitudinal strain in HF before leg up by 3D-STE were lower compared to normal (LVEF; normal: 58±5 vs HF: 39±10*% and strain; −12±3 vs −8±3%*, *p<0.05 vs normal). LVEF was increased after leg up by 7±6% in normal and by 8±8% in HF associated with increased LVED volume (normal: 84±24 to 90±24 and HF: 124±36* to 136±42*ml). LV MW and SW in HF before leg up were lower compared to normal (MW: 1790±412 vs 1002±432*mmHg% and SW: 3946±1682 vs 3352±1026mmHgml). LV SW increased after leg up by 26±19% in normal and by 25±20% in HF. LV SW-VED in normal was greater than HF (241±151 vs 90±54*).
Conclusion
LV SW noninvasively obtained by P-V loop area was increased after leg up in both normal and HF but SW-VED in HF was smaller than normal, indicating reduced contractility in HF. This noninvasive method may be a new echocardiographic approach for quantification of LV SW and contractility.
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Affiliation(s)
- T Yoshizane
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Tanaka
- Asahi University Hospital, Cardiology, Gifu, Japan
| | | | - M Otsuka
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Shoji
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - K Hattori
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Yagasaki
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - I Murata
- Gifu Prefectural General Medical Center, Nephrology, Gifu, Japan
| | - T Deguchi
- Asahi University Hospital, Cardiology, Gifu, Japan
| | - M Arai
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Okura
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
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Yoshizane T, Tanaka R, Kawasaki M, Otsuka M, Shoji T, Nagaya M, Hattori K, Murayama M, Yagasaki H, Minatoguchi S, Ono K, Tanihata S, Arai M, Noda T, Okura H. P2474Noninvasive estimation of pulmonary capillary wedge pressure by novel 3D speckle tracking echocardiography and validation study by cardiac catheterization. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0806] [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
We previously reported that pulmonary capillary wedge pressure (PCWP) was noninvasively evaluated by 2D speckle tracking echocardiography (STE). Recently, novel software was introduced to examine volume and function of left ventricular and left atrium (LA) by 3D-STE automatically.
Purpose
We sought to compare the PCWP estimated by conventional 2D-STE (2D-ePCWP) and by novel 3D-STE (3D-ePCWP), and validate those values by cardiac catheterization.
Methods
Echocardiography and catheterization were performed in 29 patients (age 72±2) (7 ischemic heart disease, 2 hypertensive heart disease, 5 dilated cardiomyopathy, 12 valvular heart disease and 3 primary pulmonary hypertension).The ePCWP (mmHg) is noninvasively obtained as 10.8 − 12.4 x Log (left atrial active emptying function/minimum volume) as we previously reported. Echocardiography was performed just before the catheterization and we analyzed the 2D and 3D data by novel off-line software. 3D data was automatically analyzed and the border settings were fixed at default (ES60, ED30) (Figure).
Results
2D-ePCWP and 3D-ePCWP had a good correlation with PCWP invasively obtained by catheterization (r=0.87 and 0.83, respectively, both p<0.001). There was an excellent correlation between 2D-ePCWP and 3D-ePCWP (r=0.94, p<0.001) and there was a good correlation between 2D-LA volume index and 3D- LA volume index (r=0.80, p<0.001). Bland-Altman analysis revealed a good agreement between 2D-ePCWP and 3D-ePCWP, and between 2D-ePCWP and 3D-ePCWP without fixed and proportional bias.
Conclusion
This study demonstrated that PCWP might be noninvasively assessed by not only 2D-STE but also 3D-STE with reasonable accuracy and 3D-STE might have utility and value in the routine clinical practice.
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Affiliation(s)
- T Yoshizane
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Tanaka
- Asahi University Hospital, Cardiology, Gifu, Japan
| | | | - M Otsuka
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Shoji
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - K Hattori
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Murayama
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Yagasaki
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Tanihata
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Arai
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Okura
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
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9
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Yoshizane T, Tanaka R, Kawasaki M, Otsuka M, Shoji T, Nagaya M, Hattori K, Yagasaki H, Minatoguchi S, Ono K, Deguchi T, Tanihata S, Arai M, Noda T, Okura H. P4351Validation by cardiac catheterization of noninvasive evaluation of left ventricular chamber and myocardial stiffness as a diastolic function using speckle tracking echocardiography. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0758] [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
Left ventricular (LV) diastolic function is mainly composed of LV relaxation and LV stiffness. We reported that pulmonary capillary wedge pressure (ePCWP) and LV relaxation assessed by Tau (eTau) are noninvasively evaluated by speckle tracking echocardiography (STE). The minimum LV diastolic pressure (mLVP) was reported to have a strong correlation with Tau. Therefore, LV chamber stiffness (c-stiffness) may be assessed with the use of two LV diastolic pressure-volume coordinates: the mLVP and volume and the end-diastolic pressure (EDP) and volume.
Purpose
We sought to noninvasively assess LV stiffness using STE and validate the value by cardiac catheterization.
Methods
Echocardiography and catheterization were performed in 124 patients (age 72±8) (70 angina pectoris, 20 prior myocardial infarction, 19 hypertensive heart disease, 11 congestive heart failure and 4 paroxysmal atrial fibrillation). The ePCWP (mmHg) is noninvasively obtained as 10.8 − 12.4 × Log (left atrial active emptying function/minimum volume) and the eTau (ms) is obtained as isovolumic relaxation time/(ln 0.9 × systolic blood pressure − ln ePCWP) as previously reported. The mLVP (e-mLVP) was estimate using Tau. The estimated EDP (e-EDP) was calculated as 12.3 − 10.1 × Log (left atrial active emptying function / minimum volume). LV c-stiffness (mmHg/ml) was calculated as LV pressure change (from mLVP to EDP) obtained by catheterization divided by LV volume change during diastole which equals to stroke volume by echocardiography. Estimated c-stiffness (e-c-stiffness) was noninvasively obtained using e-mLVP and e-EDP. Furthermore, LV myocardial stiffness (m-stiffness) was calculated by LVED stress / LV longitudinal strain by STE, where LV stress (kdynes/cm2) was calculated as 0.334 × pressure × dimension / [thickness (1 + thickness/dimension)]. The estimated m-stiffness (e-m-stiffness) was calculated using e-EDP.
Results
The eTau and e-EDP estimated by STE had a good correlation with Tau and EDP invasively obtained by catheterization (r=0.75 and 0.63, respectively, both p<0.001). There was a good correlation between Tau and mLVP (Tau = 2.06 mLVP + 33.7, r=0.70). The estimated LVED stress had good correlation with ED stress obtained by catheterization (r=0.77, p<0.001). The e-c-stiffness and e-m-stiffness had a good correlation with those obtained by catheterization (e-c-stiffness; 0.116±0.07 and c-stiffness; 0.115±0.06, r=0.603, e-m-stiffness; 0.81±0.41 and m-stiffness; 0.85±0.45, r=0.89, respectively). Bland-Altman analysis revealed a good agreement between e-c-stiffness and c-stiffness, and between e-m-stiffness and m-stiffness without fixed and proportional bias.
Conclusion
This study demonstrated that LV stiffness may be noninvasively assessed by STE with reasonable accuracy and may have utility and value in the routine clinical practice for the diagnosis and treatment in patients with diastolic dysfunction.
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Affiliation(s)
- T Yoshizane
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - R Tanaka
- Asahi University Hospital, Cardiology, Gifu, Japan
| | | | - M Otsuka
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Shoji
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Nagaya
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - K Hattori
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Yagasaki
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - S Minatoguchi
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
| | - K Ono
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Deguchi
- Asahi University Hospital, Cardiology, Gifu, Japan
| | - S Tanihata
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - M Arai
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - T Noda
- Gifu Prefectural General Medical Center, Cardiology, Gifu, Japan
| | - H Okura
- Gifu University Graduate School of Medicine, Cardiology, Gifu, Japan
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Inoue K, Arai M, Tsuruoka H, Saito K, Fujisawa M, Nakazawa S, Veerasamy N, Fukushi M. IMPACT ON ABSORBED DOSE RATE IN AIR IN KANTO REGION BY FUKUSHIMA DAIICHI NUCLEAR POWER PLANT ACCIDENT. Radiat Prot Dosimetry 2019; 184:500-503. [PMID: 31330022 DOI: 10.1093/rpd/ncz073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 04/03/2019] [Indexed: 06/10/2023]
Abstract
Absorbed dose rates in air were measured for the whole area of the Kanto region in 2015, 2016 and 2017 (n = 31 147). The mean absorbed dose rates in air for each prefecture measured by car-borne surveys were from 44 to 67 nGy h-1 (13-289 nGy h-1). The absorbed dose rate in air from artificial radionuclides (134Cs + 137Cs) measured by fixed-point observation (n = 507) was from 1 to 14 nGy h-1 (0-105 nGy h-1), and meaning that the contribution ratios of 134Cs and 137Cs were 3-22%. The deposited location of artificial radionuclides was less than 1000 m from ground level and depended on the topography, wind direction and precipitation field.
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Affiliation(s)
- K Inoue
- Department of Radiological Sciences, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo, Japan
| | - M Arai
- Department of Radiological Sciences, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo, Japan
| | - H Tsuruoka
- Department of Radiological Sciences, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo, Japan
- Department of Radiological Sciences, Tsukuba International University, 6-20-1 Manabe, Tsuchiura, Ibaraki, Japan
| | - K Saito
- Department of Radiological Technology, Faculty of Health Sciences, Nihon Institute of Medical Science, Iruma-gun, Saitama, Japan
| | - M Fujisawa
- Department of Radiological Sciences, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo, Japan
| | - S Nakazawa
- Department of Radiological Sciences, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo, Japan
| | - N Veerasamy
- Department of Radiological Sciences, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo, Japan
| | - M Fukushi
- Department of Radiological Sciences, Tokyo Metropolitan University, 7-2-10 Higashiogu, Arakawa-ku, Tokyo, Japan
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Arai M, Kim S, Ishii H, Hagiwara J, Takiguchi T, Ishiki Y, Yokota H. Delayed development of portal vein thrombosis in a patient initially detected with portal venous gas and pneumatosis intestinalis: a case report. Acute Med Surg 2019; 6:419-422. [PMID: 31592325 PMCID: PMC6773629 DOI: 10.1002/ams2.448] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 07/22/2019] [Indexed: 12/25/2022] Open
Abstract
Background Portal venous gas (PVG) and pneumatosis intestinalis (PI) are rare pathologic findings, and a delayed appearance of portal vein thrombosis (PVT) in such patients is extremely rare. Case Presentation A 51‐year‐old man complaining of epigastric pain was referred to our hospital. Computed tomography (CT) at admission revealed massive PVG and extensive PI, but no PVT. Emergency laparotomy was carried out, but bowel resection was unnecessary. On follow‐up CT on postoperative day 5, thrombosis was noted in the portal venous system, and anticoagulant was started immediately. This patient was discharged and continued to take the anticoagulant. Seven months after discharge, PVT had disappeared on CT without any thromboembolic complications. Conclusion If acute PVT is detected, anticoagulant is needed to prevent bowel ischemia and/or portal hypertension due to the growth of the thrombus. Clinicians should be aware of the potential for such a complication, and make their best efforts to exclude this entity using CT or sonography.
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Affiliation(s)
- Masatoku Arai
- Department of Emergency & Critical Care Medicine Nippon Medical School Bunkyo-ku Tokyo Japan
| | - Shiei Kim
- Department of Emergency & Critical Care Medicine Nippon Medical School Bunkyo-ku Tokyo Japan
| | - Hiromoto Ishii
- Department of Emergency & Critical Care Medicine Nippon Medical School Bunkyo-ku Tokyo Japan
| | - Jun Hagiwara
- Department of Emergency & Critical Care Medicine Nippon Medical School Bunkyo-ku Tokyo Japan
| | - Toru Takiguchi
- Department of Emergency & Critical Care Medicine Nippon Medical School Bunkyo-ku Tokyo Japan
| | - Yoshito Ishiki
- Department of Emergency & Critical Care Medicine Nippon Medical School Bunkyo-ku Tokyo Japan
| | - Hiroyuki Yokota
- Department of Emergency & Critical Care Medicine Nippon Medical School Bunkyo-ku Tokyo Japan
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Arai M, Nagata T, Sekine S, Baba H, Moriyama M, Hashimoto I, Fujii T. Abstract P2-08-50: Elevated levels of serum tumor marker p53 is a prognostic parameter and a monitoring biomarker for patients who had undergone surgical resection in breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-08-50] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Elevated levels of serum tumor maker p53 antibody is expected as an indicator of early diagnosis and a parameter of recurrence in breast cancer. P53 mutation accounts for 20% to 35% in all breast cancer patients. Preoperative high level of anti-p53 antibody in breast cancer patients tend to associate with worse prognosis. This study investigated the prognostic value of preoperative serum p53 levels, and the significance as a biomarker to evaluate a recurrence after surgical resections in breast cancer.
Methods
Preoperative serum p53 concentration levels were measured in total of 259 breast cancer patients, who had undergone either a total mastectomy or a partial mastectomy, through 2010 to 2015 in our facility. Patients with elevated levels of p53 (29 patients) and normal levels of p53 (230 patients) were compared to analyze the association of a marker level with the prognosis and the indication to diagnose recurrence in breast cancer.
Results
Elevated serum level of p53 mutation was identified in 29 (11%) patients. The size of tumor, staging, and pathology did not associate with the level of p53. Patients with elevated serum level of p53 correlated to the high score of nuclear grade (NG2 and NG3) and the high percentage of Ki-67 (>14%), which leading to the worse prognosis. Triple negative breast cancer was the major molecular subtype in the group of high level of p53 comparing with the group of low level of p53. Survival analysis using the Kaplan-Meier method were performed to examine DFS and OS of high serum level of p53 patients. Patients with high level of p53 were significantly showed worse DFS than a normal p53 group. Serum level of p53 was also reflected to the recurrence and metastasis of postoperative breast cancer. There were three patients, who had local recurrences and metastasis, in the group of high levels of p53. Their serum levels of p53 were re-elevated as emerging the local recurrence and metastasis once they had gotten the normal serum levels of p53 after surgical resections. It showed that the increasing of the level of p53 was reflected to the recurrence and metastasis of tumors after surgical resections in breast cancer.
Conclusions
This study suggests that preoperative serum level of p53 can be an independent prognostic parameter and a monitoring biomarker for breast cancer.
Citation Format: Arai M, Nagata T, Sekine S, Baba H, Moriyama M, Hashimoto I, Fujii T. Elevated levels of serum tumor marker p53 is a prognostic parameter and a monitoring biomarker for patients who had undergone surgical resection in breast cancer [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-08-50.
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Affiliation(s)
- M Arai
- University of Toyama, Toyama, Japan
| | - T Nagata
- University of Toyama, Toyama, Japan
| | - S Sekine
- University of Toyama, Toyama, Japan
| | - H Baba
- University of Toyama, Toyama, Japan
| | | | | | - T Fujii
- University of Toyama, Toyama, Japan
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Nagata T, Sekine S, Arai M, Fujii T. Abstract P2-01-22: KLF4 improve prognosis of triple negative breast cancer by suppression of epitherial mesenchymal transition. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-01-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Triple negative breast cancer (TNBC) is highly malignant and prone to metastasis and relapse, and therefore has poorer prognosis than other sub-types. The mechanism of higher malignancy of TNBC has not been sufficiently elucidated. KLF4is reported to be a transcription factor that is associated with both tumor suppression and oncogenesis. We have reported that breast cancer patients with strong expression of KLF4 had better prognosis, especially in TNBC patients. And here we report that KLF4 negatively regulates the metastasis and growth of TNBC.
Methods
We assessed the expression levels of KLF4 in 84 patients with TNBC by immunohistochemical staining and studied the patterns of metastasis/recurrence clinicopathologically. The overall survival (OS) rate and the disease free survival (DFS) rate after surgery was calculated by Kaplan-Maier method. In addition, circulating tumor cells (CTCs) in the peripheral blood of TNBC patients were identified and compared with primary lesions in terms of KLF4 expression. Moreover, the expression of KLF4 was inhibited by transfecting cultured TNBC cells (MDA-MB231) with the small interfering RNA (siRNA) of KLF4 to analyze the effects of KLF4 on cell proliferation and epithelial-mesenchymal transition (EMT)-like changes. For the proliferation assay, measurements were made by MTT assays. Cell migration and invasion assays of KLF4 suppressed TNBC cells were also examined. Total RNA was extracted from these cells, cDNA was synthesized, and used for the quantitative polymerase chain reaction (qPCR) analysis.
Results
In the 84 TNBC patients, higher KLF4 expression was associated with significantly better OS and DFS. An analysis of KLF4 expression in CTCs of the TNBC patients showed that KLF4 expression was lower in CTCs than in primary cancer lesions. TNBC cells (MDA-MB231) that were transfected the KLF4 siRNA exhibited a greater ability to growth than controls. These cells also underwent EMT-like changes with reduced expression of epithelial factors such as E-cadherin. Treating these TNBC cells with eribulin resulted a reduction of the expression of stem cell/EMT markers.
Conclusion
TNBC patients with reduced KLF4 expression had poor outcomes. The results of our experiments suggest the expression of KLF4 is one of the important factors that inhibit the EMT and growth of TNBC.
Citation Format: Nagata T, Sekine S, Arai M, Fujii T. KLF4 improve prognosis of triple negative breast cancer by suppression of epitherial mesenchymal transition [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-01-22.
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Affiliation(s)
- T Nagata
- University of Toyama, Toyama, Japan
| | - S Sekine
- University of Toyama, Toyama, Japan
| | - M Arai
- University of Toyama, Toyama, Japan
| | - T Fujii
- University of Toyama, Toyama, Japan
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Fujisawa T, Arai M, Saitoh K. Microscopic gain analysis of modulation-doped GeSn/SiGeSn quantum wells: epitaxial design toward high-temperature lasing. Opt Express 2019; 27:2457-2464. [PMID: 30732283 DOI: 10.1364/oe.27.002457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Accepted: 11/28/2018] [Indexed: 06/09/2023]
Abstract
Threshold carrier densities of GeSn quantum well (QW) lasers and the physical reason of low-temperature lasing of current GeSn laser are investigated through the comparison of threshold carrier densities of conventional III-V QW lasers. Electrons distributed over L-band is the main cause of decreased gain for GeSn QWs. To increase the gain (and improve the laser characteristics), a modulation-doped GeSn QW is proposed and the material gain is analyzed based on many-body theory for both qualitative and quantitative simulation. Significant gain increase can be expected for n-type modulation doping QWs. The doping condition for elevated temperature lasing is discussed and it was found that material gain curve similar to III-V QW is obtained for GeSn QW with n-type modulation doping of 6 × 1018 cm-3. It was also found that unlike III-V QW lasers, n-type modulation doping is more effective for high-speed operation in terms of differential gain than p-type modulation doping.
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Yanagi M, Suzuki Y, Hamasaki T, Mizunuma K, Arai M, Yokota H, Murata S, Kondo Y, Nishimura T. Early Transcatheter Arterial Embolization for the American Association for the Surgery of Trauma Grade 4 Blunt Renal Trauma in Two Institutions. J NIPPON MED SCH 2018; 85:204-207. [PMID: 30259888 DOI: 10.1272/jnms.jnms.2018_85-31] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To evaluate the efficacy of early transcatheter arterial embolization for hemodynamically stable patients with The American Association for the Surgery of Trauma (AAST) grade 4 blunt renal trauma. MATERIALS AND METHODS The medical records of consecutive patients with grade 4 blunt renal trauma who were transported to our two critical care centers in Japan and treated with early transcatheter arterial embolization (TAE) between 2001 and 2013 were retrospectively reviewed. Treatment failure was defined as the need for further surgical intervention or re-embolization after initial embolization. We divided these cases into two groups, a group who survived and a group who died, investigating the factors that led to death. RESULTS Seventeen patients underwent early TAE, with an average time between presentation and embolization for renal trauma of 125 minutes (66-214 minutes). There was no case of treatment failure. Three of the patients died, but none solely because of renal injury. Significant factors associated with patient death were the number of concomitant injured organs (p=0.04), the presence of pelvic fractures (p<0.01), and the presence of visceral injuries (p<0.01). The presence of lumber fractures (p=0.09) also tended to be associated with patient death. CONCLUSIONS Early TAE is an effective treatment and should be actively performed for hemodynamically stable patients with grade 4 blunt renal injuries without multiple concomitant organ injuries.
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Affiliation(s)
- Masato Yanagi
- Department of Urology (Chief: Y. Suzuki), Nippon Medical School Chiba Hokusoh Hospital.,Department of Urology (Chairman and Professor: Y. Kondo), Nippon Medical School
| | - Yasutomo Suzuki
- Department of Urology (Chief: Y. Suzuki), Nippon Medical School Chiba Hokusoh Hospital.,Department of Urology (Chairman and Professor: Y. Kondo), Nippon Medical School
| | - Tsutomu Hamasaki
- Department of Urology (Chairman and Professor: Y. Kondo), Nippon Medical School
| | | | - Masatoku Arai
- Department of Emergency and Critical Care Medicine, (Chairman and Professor: H. Yokota), Nippon Medical School
| | - Hiroyuki Yokota
- Department of Emergency and Critical Care Medicine, (Chairman and Professor: H. Yokota), Nippon Medical School
| | - Satoru Murata
- Department of Radiology (Chairman and Professor: S. Kumita), Nippon Medical School
| | - Yukihiro Kondo
- Department of Urology (Chairman and Professor: Y. Kondo), Nippon Medical School
| | - Taiji Nishimura
- Department of Urology (Chief: S. Kurita), Tachikawa Sogo Hospital
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Nomura H, Sekine M, Yokoyama S, Takeshima N, Arai M, Nakamura S. Clinical background and outcomes of risk-reducing salpingo-oophorectomy for patients with hereditary breast and ovarian cancer in Japan. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy436.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sasaki-Honda M, Jonouchi T, Arai M, Hotta A, Mitsuhashi S, Nishino I, Matsuda R, Sakurai H. NEW GENES, FUNCTIONS AND BIOMARKERS. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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18
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Arai M, Kim S, Yokota H. Staged Strategy for Early Abdominal Wall Closure in a Case Involving Ruptured Abdominal Aortic Aneurysm Requiring Open Abdomen in Which Primary Fascial Closure was Difficult to Achieve: A Case Report. Chirurgia (Bucur) 2018; 113:558-563. [PMID: 30183587 DOI: 10.21614/chirurgia.113.4.558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/01/2018] [Indexed: 11/23/2022]
Abstract
Open abdomen is sometimes necessary to save lives after ruptured abdominal aortic aneurysm repair. We report a case in which a staged strategy for early abdominal wall closure was applied to prevent the severe complications due to the extended period of open abdomen. An 81-year-old man with ruptured abdominal aortic aneurysm was transported to our hospital. After the first operation, which required open abdomen, prolonged visceral edema and retroperitoneal hematoma made primary fascial closure difficult. Mesh mediated fascial traction was undergone to reduce the gap in fascial dehiscence under negative pressure wound therapy. However, primary fascial closure could not be accomplished, and abdominal wall reconstruction was performed using bilateral anterior rectus abdominis sheath turnover flap method. Moreover, the skin along the abdominal wall was too tight to be closed primarily. Thus, a bipedicled skin flap was applied. The patient was transferred to another hospital without any remarkable complications. In the present case, the application of a staged closure strategy, which was based on the duration of open abdomenand the condition of the fascia and skin was considered to be important for achieving definitive abdominal closure and preventing the severe complications.
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Arai M, Kim S, Ishii H, Hagiwara J, Kushimoto S, Yokota H. The long-term outcomes of early abdominal wall reconstruction by bilateral anterior rectus abdominis sheath turnover flap method in critically ill patients requiring open abdomen. World J Emerg Surg 2018; 13:39. [PMID: 30202428 PMCID: PMC6123919 DOI: 10.1186/s13017-018-0200-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 08/22/2018] [Indexed: 12/19/2022] Open
Abstract
Background In a previous study, we reported the usefulness of early abdominal wall reconstruction using bilateral anterior rectus abdominis sheath turnover flap method (turnover flap method) in open abdomen (OA) patients in whom early primary fascial closure was difficult to achieve. However, the long-term outcomes have not been elucidated. In the present study, we aimed to evaluate the procedure, particularly in terms of ventral hernia, pain, and daily activities. Methods Between 2001 and 2013, 15 consecutive patients requiring OA after emergency laparotomy and in whom turnover flap method was applied were retrospectively identified. The long-term outcomes were evaluated based on medical records, physical examinations, CT imaging, and a ventral hernia pain questionnaire (VHPQ). Results The turnover flap method was applied in 2 trauma and 13 non-trauma patients.In most of cases, primary fascial closure could not be achieved due to massive visceral edema. The turnover flap method was performed for abdominal wall reconstruction at the end of OA. The median duration of OA was 6 (range 1-42) days. One of the 15 patients died of multiple organ failure during initial hospitalization after the performance of the turnover flap method. Fourteen patients survived, and although wound infection was observed in 3 patients, none showed enteric fistula, abdominal abscess, graft infection, or ventral hernia during hospitalization. However, it was found that 1 patient developed ventral hernia during follow-up at an outpatient visit. Nine of 14 patients were alive and able to be evaluated with a VHPQ (follow-up period: median 10 years; range 3-15 years). Seven out of nine patients were satisfied with this procedure, and none complained of pain or were limited in their daily activities. Conclusions Based on the results of this study, early abdominal reconstruction using the turnover flap method can be considered to be safe and effective as an alternative technique for OA patients in whom primary fascial closure is considered difficult to achieve.
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Affiliation(s)
- Masatoku Arai
- Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603 Japan
| | - Shiei Kim
- Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603 Japan
| | - Hiromoto Ishii
- Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603 Japan
| | - Jun Hagiwara
- Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603 Japan
| | - Shigeki Kushimoto
- Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574 Japan
| | - Hiroyuki Yokota
- Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603 Japan
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Shiratani T, Hobara R, Natsuki I, Arai M. Remote after-effects of resistive static contractions of lower trunk depressors and upper extremity on maximal active range of motion of ankle extension in ankle fractures. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Katakami N, Harada T, Murata T, Shinozaki K, Tsutsumi M, Yokota T, Arai M, Tada Y, Narabayashi M, Boku N. Randomized phase III and extension studies: efficacy and impacts on quality of life of naldemedine in subjects with opioid-induced constipation and cancer. Ann Oncol 2018; 29:1461-1467. [PMID: 32151367 PMCID: PMC6005145 DOI: 10.1093/annonc/mdy118] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [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] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The efficacy and safety of naldemedine (a peripherally acting µ-opioid receptor antagonist) for opioid-induced constipation (OIC) in subjects with cancer was demonstrated in the primary report of a phase III, double-blind study (COMPOSE-4) and its open-label extension (COMPOSE-5). The primary end point, the proportion of spontaneous bowel movement (SBM) responders, was met. Here, we report results from secondary end points, including quality of life (QOL) assessments from these studies. PATIENTS AND METHODS In COMPOSE-4, eligible adults with OIC and cancer were randomly assigned 1:1 to receive once-daily oral naldemedine 0.2 mg (n = 97) or placebo (n = 96) for 2 weeks, and those who continued on to COMPOSE-5 received naldemedine for 12 weeks (n = 131). Secondary assessments in COMPOSE-4 included the proportion of complete SBM (CSBM) responders, SBM or CSBM responders by week, and subjects with ≥1 SBM or CSBM within 24 h postinitial dose. Changes from baseline in the frequency of SBMs or CSBMs per week were assessed at weeks 1 and 2. Time to the first SBM or CSBM postinitial dose was also evaluated. In both studies, QOL impact was evaluated by Patient Assessment of Constipation-Symptoms (PAC-SYM) and PAC-QOL questionnaires. RESULTS Naldemedine improved bowel function for all secondary efficacy assessments versus placebo (all P ≤ 0.0002). The timely onset of naldemedine activity versus placebo was evidenced by median time to the first SBM (4.7 h versus 26.6 h) and CSBM (24.0 h versus 218.5 h) postinitial dose (all P < 0.0001). In COMPOSE-4, significant differences between groups were observed with the PAC-SYM stool domain (P = 0.045) and PAC-QOL dissatisfaction domain (P = 0.015). In COMPOSE-5, significant improvements from baseline were observed for overall and individual domain scores of PAC-SYM and PAC-QOL. CONCLUSIONS Naldemedine provided effective and timely symptomatic relief from OIC and improved the QOL of subjects with OIC and cancer. TRIAL REGISTRATION ID: www.ClinicalTrials.jp: JAPIC-CTI-132340 (COMPOSE-4) and JAPIC-CTI-132342 (COMPOSE-5).
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Affiliation(s)
- N Katakami
- Kobe City Medical Center General Hospital, Kobe, Japan.
| | - T Harada
- Center for Respiratory Diseases, JCHO Hokkaido Hospital, Sapporo, Japan
| | - T Murata
- Department of Breast Oncology, Aichi Cancer Center Aichi Hospital, Okazaki, Japan
| | - K Shinozaki
- Department of Clinical Oncology, Hiroshima Prefectural Hospital, Hiroshima, Japan
| | - M Tsutsumi
- Department of Urology, Hitachi General Hospital, Hitachi, Japan
| | - T Yokota
- Global Development, Shionogi & Co., Ltd, Osaka, Japan
| | - M Arai
- Global Development, Shionogi & Co., Ltd, Osaka, Japan
| | - Y Tada
- Global Development, Shionogi & Co., Ltd, Osaka, Japan
| | - M Narabayashi
- Department of Palliative Therapy, Cancer Institute Hospital of JFCR, Tokyo, Japan
| | - N Boku
- Division of Gastrointestinal Medical Oncology, National Cancer Center Hospital, Tokyo, Japan
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Yamauchi H, Okawa M, Yokoyama S, Nakamura S, Arai M. Abstract PD1-09: High incidence rate of occult cancer in risk reducing mastectomy specimens despite thorough assessment with breast MRI and ultrasound-findings from the hereditary breast and ovarian cancer registration 2016 in Japan. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd1-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction:One of the preemptive strategies for Hereditary Breast and Ovarian Cancer (HBOC) is prophylactic surgery. Data for risk reducing mastectomy (RRM) clearly showed a risk reduction of more than 90% for breast cancer.
Method: We report here the statistical results of the HBOC registration up to 2016. The subjects of this study were those who underwent BRCA1/2 genetic testing during the study period, at 7 medical institutions.
Results: A total of 1527 probands underwent BRCA testing; 1125 cases (73.7%) were negative for BRCA1/2 mutation, and 297 cases (19.5%) were positive, while 105 cases (6.9%) had uncertain results. Among the 297 cases with positive results, 157 cases (10.3%) were positive for BRCA1, 139 cases (9.1%) for BRCA2, and 1 case (0.1%) was positive for both.The mean age at breast cancer diagnosis was 41.7 years in BRCA1/2 mutation positive and 45.8 years in negative cases. In comparison to the National Registration for Breast Cancer Incidence 2011 in Japan (n=72,472), breast cancer with BRCA mutations occurred at a younger age. Among 359 cases of triple negative breast cancer, 101 cases (28.3%) were BRCA1 mutation positive while 18 cases (5.0%) were BRCA2 mutation positive.
Three hundred seventy cases underwent genetic testing prior to surgery, as a deciding factor for the surgical procedure. Among BRCA mutation positive cases, 58 cases (87.9%) chose to undergo total mastectomy, and 8 cases (12.1%) chose breast conserving surgery (BCS); on the other hand, 141 cases (46.4%) of BRCA mutation negative cases chose total mastectomy and 158 cases (52.0%) chose BCS.
Four cases of new onset breast cancers were observed among the 55 cases of previvors (mean observation period: 2.5 years; incidence rate: 2.9%/Y). Among the 73 BRCA1/2 mutation positive women who underwent BCS, 3 ipsilateral breast cancer cases were observed (mean observation period: 3.5 years; incidence rate: 1.2%/Y), while 2 cases were noted among 477 cases of BRCA1/2 mutation negative cases (mean observation period: 2.2 years; incidence rate: 0.2%/Y). Of 189 BRCA1/2 mutation positive cases with unilateral breast cancer, 8 contralateral breast cancer cases were noted (mean observation period: 3.0 years; incidence rate: 1.4%/Y), while 4 cases of contralateral breast cancer were observed among 892 cases of BRCA1/2 mutation negative cases (mean observation period: 2.2 years; incidence rate: 0.2%/Y).
Fifty-one patients had undergone RRM.Six cases (11.8%) of occult breast cancer were noted in the RRM specimens, among which 2 were BRCA1 positive cases and 4 were BRCA2 positive cases. All of these six cases had undergone extensive imaging work-up prior to surgery by using mammography, ultrasound and breast MRI.
Conclusions: The incidence rate of occult cancer after risk-reducing mastectomy was reported to be about 5% in the high-risk population. Our report showed a relatively higher incidence rate of occult cancer at 11.8% among BRCA mutation positive cases, despite thorough pre-operative radiological evaluations, which included a breast MRI. These results suggest the limitations in the use of MRI for the surveillance of patients with BRCA mutations.
Citation Format: Yamauchi H, Okawa M, Yokoyama S, Nakamura S, Arai M. High incidence rate of occult cancer in risk reducing mastectomy specimens despite thorough assessment with breast MRI and ultrasound-findings from the hereditary breast and ovarian cancer registration 2016 in Japan [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD1-09.
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Affiliation(s)
- H Yamauchi
- Breast Center, St. Luke's International Hospital, Tokyo, Japan; Breast Center, Showa University, Tokyo, Japan; Clinical Genetic Oncology, Tokyo, Japan
| | - M Okawa
- Breast Center, St. Luke's International Hospital, Tokyo, Japan; Breast Center, Showa University, Tokyo, Japan; Clinical Genetic Oncology, Tokyo, Japan
| | - S Yokoyama
- Breast Center, St. Luke's International Hospital, Tokyo, Japan; Breast Center, Showa University, Tokyo, Japan; Clinical Genetic Oncology, Tokyo, Japan
| | - S Nakamura
- Breast Center, St. Luke's International Hospital, Tokyo, Japan; Breast Center, Showa University, Tokyo, Japan; Clinical Genetic Oncology, Tokyo, Japan
| | - M Arai
- Breast Center, St. Luke's International Hospital, Tokyo, Japan; Breast Center, Showa University, Tokyo, Japan; Clinical Genetic Oncology, Tokyo, Japan
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Arai M, Kim S, Ishii H, Hagiwara J, Kushimoto S, Yokota H. The long-term outcomes of early abdominal wall reconstruction by bilateral anterior rectus abdominis sheath turnover flap method in critically ill patients requiring open abdomen. World J Emerg Surg 2018; 13:39. [PMID: 30202428 DOI: 10.1186/s13017-018-0200-7)] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 08/22/2018] [Indexed: 05/21/2023] Open
Abstract
BACKGROUND In a previous study, we reported the usefulness of early abdominal wall reconstruction using bilateral anterior rectus abdominis sheath turnover flap method (turnover flap method) in open abdomen (OA) patients in whom early primary fascial closure was difficult to achieve. However, the long-term outcomes have not been elucidated. In the present study, we aimed to evaluate the procedure, particularly in terms of ventral hernia, pain, and daily activities. METHODS Between 2001 and 2013, 15 consecutive patients requiring OA after emergency laparotomy and in whom turnover flap method was applied were retrospectively identified. The long-term outcomes were evaluated based on medical records, physical examinations, CT imaging, and a ventral hernia pain questionnaire (VHPQ). RESULTS The turnover flap method was applied in 2 trauma and 13 non-trauma patients.In most of cases, primary fascial closure could not be achieved due to massive visceral edema. The turnover flap method was performed for abdominal wall reconstruction at the end of OA. The median duration of OA was 6 (range 1-42) days. One of the 15 patients died of multiple organ failure during initial hospitalization after the performance of the turnover flap method. Fourteen patients survived, and although wound infection was observed in 3 patients, none showed enteric fistula, abdominal abscess, graft infection, or ventral hernia during hospitalization. However, it was found that 1 patient developed ventral hernia during follow-up at an outpatient visit. Nine of 14 patients were alive and able to be evaluated with a VHPQ (follow-up period: median 10 years; range 3-15 years). Seven out of nine patients were satisfied with this procedure, and none complained of pain or were limited in their daily activities. CONCLUSIONS Based on the results of this study, early abdominal reconstruction using the turnover flap method can be considered to be safe and effective as an alternative technique for OA patients in whom primary fascial closure is considered difficult to achieve.
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Affiliation(s)
- Masatoku Arai
- 1Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603 Japan
| | - Shiei Kim
- 1Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603 Japan
| | - Hiromoto Ishii
- 1Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603 Japan
| | - Jun Hagiwara
- 1Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603 Japan
| | - Shigeki Kushimoto
- 2Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574 Japan
| | - Hiroyuki Yokota
- 1Department of Emergency and Critical Care Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603 Japan
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24
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Ishida YI, Kayama T, Kibune Y, Nishimoto S, Koike S, Suzuki T, Horiuchi Y, Miyashita M, Itokawa M, Arai M, Ogasawara Y. Identification of an argpyrimidine-modified protein in human red blood cells from schizophrenic patients: A possible biomarker for diseases involving carbonyl stress. Biochem Biophys Res Commun 2017; 493:573-577. [PMID: 28867194 DOI: 10.1016/j.bbrc.2017.08.150] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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: 08/15/2017] [Accepted: 08/25/2017] [Indexed: 12/14/2022]
Abstract
Argpyrimidine (ARP) is an advanced glycation end product thought to be generated from a reaction between methylglyoxal and arginine residues in proteins. In this study, we observed marked accumulation of an approximately 56 kD protein, reactive to anti-ARP antibodies, in the red blood cells (RBCs) of some patients with refractory schizophrenia. This ARP-modified protein was purified from the blood of schizophrenic patients and identified as selenium binding protein 1 (SBP1) by LC-MS/MS. This is the first report of ARP-modified proteins accumulating in RBCs of patients with diseases involving carbonyl stress. We also observed high accumulation of ARP-modified SBP1 in the RBCs of patients with chronic kidney disease. Therefore, this modified protein may be a novel marker of carbonyl stress.
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Affiliation(s)
- Y I Ishida
- Department of Molecular and Cellular Biochemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Nishitokyo, Tokyo 204-8588, Japan
| | - T Kayama
- Department of Analytical Biohemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Nishitokyo, Tokyo 204-8588, Japan
| | - Y Kibune
- Department of Analytical Biohemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Nishitokyo, Tokyo 204-8588, Japan
| | - S Nishimoto
- Department of Analytical Biohemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Nishitokyo, Tokyo 204-8588, Japan
| | - S Koike
- Department of Analytical Biohemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Nishitokyo, Tokyo 204-8588, Japan
| | - T Suzuki
- Department of Analytical Biohemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Nishitokyo, Tokyo 204-8588, Japan
| | - Y Horiuchi
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Kamikitazawa, Setagaya, Tokyo 156-8506, Japan
| | - M Miyashita
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Kamikitazawa, Setagaya, Tokyo 156-8506, Japan
| | - M Itokawa
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Kamikitazawa, Setagaya, Tokyo 156-8506, Japan
| | - M Arai
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Kamikitazawa, Setagaya, Tokyo 156-8506, Japan
| | - Y Ogasawara
- Department of Analytical Biohemistry, Meiji Pharmaceutical University, 2-522-1 Noshio, Kiyose, Nishitokyo, Tokyo 204-8588, Japan.
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25
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Yoshizane T, Kawasaki M, Tanaka R, Horio S, Ishiguro M, Minatoguchi S, Warita S, Ono K, Nagaya M, Tanihata S, Arai M, Noda T, Watanabe S, Minatoguchi S. P5231Left ventricular strain rate during diastole assessed by real-time one-beat three-dimensional speckle tracking echocardiography with high volume rates: comparison with doppler echocardiography. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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26
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Yoshizane T, Kawasaki M, Tanaka R, Horio S, Ishiguro M, Minatoguchi S, Warita S, Ono K, Sato H, Tanihata S, Arai M, Noda T, Watanabe S, Minatoguchi S. P3337Left ventricular torsion is more useful index of systolic performance than twist: one-beat real time three-dimensional speckle tracking echocardiography study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p3337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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27
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Yoshizane T, Kawasaki M, Tanaka R, Horio S, Ishiguro M, Minatoguchi S, Warita S, Ono K, Deguchi T, Tanihata S, Arai M, Noda T, Watanabe S, Minatoguchi S. P4369Left ventricular layer strain and torsion in hypertensive heart failure with preserved and reduced ejection fraction: 3-dimensional speckle tracking echocardiography studv. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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28
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Yoshizane T, Kawasaki M, Tanaka R, Horio S, Ishiguro M, Minatoguchi S, Warita S, Kawamura I, Ono K, Tanihata S, Arai M, Noda T, Watanabe S, Minatoguchi S. P6166Noninvesive evaluation of impact of left ventricular pressure overload on diastolic function in patients with preserved ejection fraction using speckle tracking echocardiography: multicenter study. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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29
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Watanabe I, Watanabe R, Okumura Y, Nagashima K, Iso K, Takahashi K, Arai M, Kurokawa S, Ohkubo K, Nakai T, Hirayama A. P865Association between serum adiponectin, female sex, NT-proBNP, and post-ablation recurrence of atrial fibrillation. Europace 2017. [DOI: 10.1093/ehjci/eux151.047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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30
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Kushima I, Aleksic B, Nakatochi M, Shimamura T, Shiino T, Yoshimi A, Kimura H, Takasaki Y, Wang C, Xing J, Ishizuka K, Oya-Ito T, Nakamura Y, Arioka Y, Maeda T, Yamamoto M, Yoshida M, Noma H, Hamada S, Morikawa M, Uno Y, Okada T, Iidaka T, Iritani S, Yamamoto T, Miyashita M, Kobori A, Arai M, Itokawa M, Cheng MC, Chuang YA, Chen CH, Suzuki M, Takahashi T, Hashimoto R, Yamamori H, Yasuda Y, Watanabe Y, Nunokawa A, Someya T, Ikeda M, Toyota T, Yoshikawa T, Numata S, Ohmori T, Kunimoto S, Mori D, Iwata N, Ozaki N. High-resolution copy number variation analysis of schizophrenia in Japan. Mol Psychiatry 2017; 22:430-440. [PMID: 27240532 DOI: 10.1038/mp.2016.88] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [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] [Received: 09/20/2015] [Revised: 04/18/2016] [Accepted: 04/20/2016] [Indexed: 12/30/2022]
Abstract
Recent schizophrenia (SCZ) studies have reported an increased burden of de novo copy number variants (CNVs) and identified specific high-risk CNVs, although with variable phenotype expressivity. However, the pathogenesis of SCZ has not been fully elucidated. Using array comparative genomic hybridization, we performed a high-resolution genome-wide CNV analysis on a mainly (92%) Japanese population (1699 SCZ cases and 824 controls) and identified 7066 rare CNVs, 70.0% of which were small (<100 kb). Clinically significant CNVs were significantly more frequent in cases than in controls (odds ratio=3.04, P=9.3 × 10-9, 9.0% of cases). We confirmed a significant association of X-chromosome aneuploidies with SCZ and identified 11 de novo CNVs (e.g., MBD5 deletion) in cases. In patients with clinically significant CNVs, 41.7% had a history of congenital/developmental phenotypes, and the rate of treatment resistance was significantly higher (odds ratio=2.79, P=0.0036). We found more severe clinical manifestations in patients with two clinically significant CNVs. Gene set analysis replicated previous findings (e.g., synapse, calcium signaling) and identified novel biological pathways including oxidative stress response, genomic integrity, kinase and small GTPase signaling. Furthermore, involvement of multiple SCZ candidate genes and biological pathways in the pathogenesis of SCZ was suggested in established SCZ-associated CNV loci. Our study shows the high genetic heterogeneity of SCZ and its clinical features and raises the possibility that genomic instability is involved in its pathogenesis, which may be related to the increased burden of de novo CNVs and variable expressivity of CNVs.
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Affiliation(s)
- I Kushima
- Institute for Advanced Research, Nagoya University, Nagoya, Japan.,Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - B Aleksic
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - M Nakatochi
- Bioinformatics Section, Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - T Shimamura
- Division of Systems Biology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Shiino
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - A Yoshimi
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - H Kimura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Y Takasaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - C Wang
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - J Xing
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - K Ishizuka
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Oya-Ito
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Y Nakamura
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Y Arioka
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Center for Advanced Medicine and Clinical Research, Nagoya University Hospital, Nagoya, Japan
| | - T Maeda
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - M Yamamoto
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - M Yoshida
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - H Noma
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - S Hamada
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - M Morikawa
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Y Uno
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Okada
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Iidaka
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - S Iritani
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Yamamoto
- Department of Legal Medicine and Bioethics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - M Miyashita
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - A Kobori
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - M Arai
- Department of Psychiatry and Behavioral Sciences, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - M Itokawa
- Center for Medical Cooperation, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - M-C Cheng
- Department of Psychiatry, Yuli Mental Health Research Center, Yuli Branch, Taipei Veterans General Hospital, Hualien, Taiwan
| | - Y-A Chuang
- Department of Psychiatry, Yuli Mental Health Research Center, Yuli Branch, Taipei Veterans General Hospital, Hualien, Taiwan
| | - C-H Chen
- Department of Psychiatry, Chang Gung Memorial Hospital-Linkou, Taoyuan, Taiwan.,Department and Graduate Institute of Biomedical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - M Suzuki
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - T Takahashi
- Department of Neuropsychiatry, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan
| | - R Hashimoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Suita, Japan.,Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - H Yamamori
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Yasuda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Watanabe
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - A Nunokawa
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - T Someya
- Department of Psychiatry, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - M Ikeda
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - T Toyota
- Laboratory for Molecular Psychiatry, RIKEN Brain Science Institute, Wako, Japan
| | - T Yoshikawa
- Laboratory for Molecular Psychiatry, RIKEN Brain Science Institute, Wako, Japan
| | - S Numata
- Department of Psychiatry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - T Ohmori
- Department of Psychiatry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - S Kunimoto
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - D Mori
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Brain and Mind Research Center, Nagoya University, Nagoya, Japan
| | - N Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan
| | - N Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
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31
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Ichikawa W, Uehara K, Minamimura K, Tanaka C, Takii Y, Miyauchi H, Sadahiro S, Shinozaki K, Fukumoto K, Otsuji T, Kambara T, Morita S, Ando Y, Arai M, Sugihara M, Sugiyama T, Ohashi Y, Sakata Y. A nomogram for predicting overall survival (OS) in Japanese patients (pts) with advanced colorectal cancer (aCRC) treated with irinotecan (IRI)-based regimens. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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32
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Murata T, Katakami N, Harada T, Shinozaki K, Tsutsumi M, Yokota T, Arai M, Suzuki Y, Narabayashi M, Boku N. Treatment of opioid-induced constipation with naldemedine in patients with cancer: onset of action in a randomized phase 3 trial. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw390.34] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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33
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Yokoo T, Iwase K, Itoh S, Kamiyama T, Arai M, Akiba E. Neutron cross section with chemical binding energy: The application on pulsed neutron diffraction. JNR 2016. [DOI: 10.3233/jnr-150022] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- T. Yokoo
- Institute of Materials Structure Science, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
- Materials and Life Science Division, J-PARC Center, Tokai, Ibaraki, Japan
| | - K. Iwase
- Frontier Research Center of Applied Nuclear Science, Ibaraki University, Tokai, Ibaraki, Japan
| | - S. Itoh
- Institute of Materials Structure Science, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
- Materials and Life Science Division, J-PARC Center, Tokai, Ibaraki, Japan
| | - T. Kamiyama
- Institute of Materials Structure Science, High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki, Japan
- Materials and Life Science Division, J-PARC Center, Tokai, Ibaraki, Japan
| | - M. Arai
- Materials and Life Science Division, J-PARC Center, Tokai, Ibaraki, Japan
| | - E. Akiba
- National Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki, Japan
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34
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Oshitari T, Shimizu N, Tatsumi T, Takatsuna Y, Arai M, Sato E, Yamamoto S. Comparison of efficacy of intravitreal ranibizumab and aflibercept in eyes with diabetic macular edema. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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35
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Shimakawa Y, Njai HF, Takahashi K, Berg L, Ndow G, Jeng-Barry A, Ceesay A, Tamba S, Opoku E, Taal M, Akbar SMF, Arai M, D'Alessandro U, Taylor-Robinson SD, Njie R, Mishiro S, Thursz MR, Lemoine M. Hepatitis E virus infection and acute-on-chronic liver failure in West Africa: a case-control study from The Gambia. Aliment Pharmacol Ther 2016; 43:375-84. [PMID: 26623967 DOI: 10.1111/apt.13484] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [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] [Received: 08/04/2015] [Revised: 09/17/2015] [Accepted: 11/04/2015] [Indexed: 12/12/2022]
Abstract
BACKGROUND In sub-Saharan Africa, it is unknown whether hepatitis E virus (HEV) infection is a common precipitating event of acute-on-chronic liver failure (ACLF). AIMS To estimate the prevalence of HEV infection in general population and assess whether HEV is a common trigger of ACLF in cirrhotic patients in The Gambia, West Africa. METHODS We first conducted an HEV sero-survey in healthy volunteers. We then tested cirrhotic patients with ACLF (cases) and compensated cirrhosis (controls) for anti-HEV IgG as a marker of exposure to HEV, and anti-HEV IgA and HEV RNA as a marker of recent infection. We also described the characteristics and survival of the ACLF cases and controls. RESULTS In the healthy volunteers (n = 204), 13.7% (95% CI: 9.6-19.2) were positive for anti-HEV IgG, and none had positive HEV viraemia. After adjusting for age and sex, the following were associated with positive anti-HEV IgG: being a Christian, a farmer, drinking water from wells, handling pigs and eating pork. In 40 cases (median age: 45 years, 72.5% male) and 71 controls (39 years, 74.6% male), ≥70% were infected with hepatitis B virus. Although hepatitis B flare and sepsis were important precipitating events of ACLF, none had marker of acute HEV. ACLF cases had high (70.0%) 28-day mortality. CONCLUSIONS Hepatitis E virus infection is endemic in The Gambia, where both faecal-oral route (contaminated water) and zoonotic transmission (pigs/pork meat) may be important. However, acute HEV was not a common cause of acute-on-chronic liver failure in The Gambia.
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Affiliation(s)
- Y Shimakawa
- MRC Unit The Gambia, Banjul, The Gambia.,Unité d'Épidémiologie des Maladies Émergentes, Institut Pasteur, Paris, France
| | - H F Njai
- MRC Unit The Gambia, Banjul, The Gambia
| | - K Takahashi
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | - L Berg
- MRC Unit The Gambia, Banjul, The Gambia.,Hepatology Unit, Department of Medicine, Imperial College London, London, UK
| | - G Ndow
- MRC Unit The Gambia, Banjul, The Gambia.,Hepatology Unit, Department of Medicine, Imperial College London, London, UK
| | | | - A Ceesay
- MRC Unit The Gambia, Banjul, The Gambia
| | - S Tamba
- MRC Unit The Gambia, Banjul, The Gambia
| | - E Opoku
- MRC Unit The Gambia, Banjul, The Gambia.,Hepatology Unit, Department of Medicine, Imperial College London, London, UK
| | - M Taal
- Ministry of Health and Social Welfare, Banjul, The Gambia
| | - S M F Akbar
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | - M Arai
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | | | - S D Taylor-Robinson
- Hepatology Unit, Department of Medicine, Imperial College London, London, UK
| | - R Njie
- MRC Unit The Gambia, Banjul, The Gambia.,The Gambia Hepatitis Intervention Study, IARC, c/o MRC Unit, Banjul, The Gambia
| | - S Mishiro
- Department of Medical Sciences, Toshiba General Hospital, Tokyo, Japan
| | - M R Thursz
- Hepatology Unit, Department of Medicine, Imperial College London, London, UK
| | - M Lemoine
- MRC Unit The Gambia, Banjul, The Gambia.,Hepatology Unit, Department of Medicine, Imperial College London, London, UK
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Arai M, Kudo Y, Miki N. Electroencephalogram measurement from the hairy part of the scalp using polymer-based dry microneedle electrodes. Annu Int Conf IEEE Eng Med Biol Soc 2016; 2015:3165-8. [PMID: 26736964 DOI: 10.1109/embc.2015.7319064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This paper reports a successful electroencephalogram (EEG) measurement from the hairy part of the scalp using a polymer-based dry microneedle electrode. The electrode consists of 25 pillars, each of which has a sharp microneedle on the top. Hairs are collected into the gaps of the pillars and the microneedles can reach the scalp surface. Since the microneedles can penetrate through the stratum corneum, no conductive gel is necessary to acquire high quality EEG. We experimentally investigated the pillar diameters in EEG measurement from the occipital region with hairs. The fabricated electrodes successfully measured EEG without any skin preparation or conductive gel.
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37
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Matsumura T, Arai M, Ishigami H, Okimoto K, Saito K, Minemura S, Maruoka D, Nakagawa T, Katsuno T, Yokosuka O. A randomized controlled trial comparing a prepackaged low-residue diet with a restricted diet for colonoscopy preparation: the impact on the results of colonoscopy in adenoma detection. Colorectal Dis 2016; 18:O37-42. [PMID: 26496937 DOI: 10.1111/codi.13167] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2015] [Accepted: 09/04/2015] [Indexed: 02/08/2023]
Abstract
AIM This study aimed to investigate the clinical utility of a prepackaged low-residue diet (PLD) compared with a restricted diet (RD) for colonoscopic bowel preparation. METHOD A prospective randomized controlled trial was carried out with patients undergoing colonoscopy. One hundred patients were randomly assigned to PLD and RD groups. In the RD group, the patients received an information sheet containing acceptable low-residue options and instructions from the medical staff. All patients received 10 ml sodium picosulphate the day before colonoscopy and 1 l of polyethylene glycol with ascorbic acid (PEG-A) on the day of the colonoscopy. If the bowel preparation was not adequate, an additional PEG-A solution was given. The primary outcome was the efficacy of colonic cleansing as rated by the Boston Bowel Preparation Scale (BBPS). The additional amount of PEG-A solution, adenoma detection rate and patient tolerance were assessed as secondary outcomes. RESULTS The BBPS score in the PLD group was 7.3 ± 1.7 compared with 6.5 ± 1.7 in the RD group. The quality of bowel preparation was significantly better in the PLD group (P < 0.05). The mean amount of additional PEG-A solution in the PLD group was smaller than in the RD group (293.8 ± 474.8 vs 444.1 ± 625.0 ml), but there was no statistical difference between the two groups. Adenoma detection rates and patient tolerance were similar in the two groups. CONCLUSION Prepackaged low-residue diets PLD is superior to RD for bowel preparation for colonoscopy.
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Affiliation(s)
- T Matsumura
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - M Arai
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - H Ishigami
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - K Okimoto
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - K Saito
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - S Minemura
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - D Maruoka
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - T Nakagawa
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - T Katsuno
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - O Yokosuka
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
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38
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Arai M, Koike T, Moriyasu M, Ito S, Ootsuka T, Inagaki T, Hattori J, Yoshino K, Kuroiwa M. Implementation of critical care staff based rapid response team. effect of rapid response system to the unpredicted death. Intensive Care Med Exp 2015. [PMCID: PMC4796971 DOI: 10.1186/2197-425x-3-s1-a67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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39
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Chino A, Nagayama S, Ishikawa H, Morishige K, Kishihara T, Arai M, Sugiura Y, Motoi N, Yamamoto N, Tamegai Y, Igarashi M. Cancer emerging from the recurrence of sessile serrated adenoma/polyp resected endoscopically 5 years ago. Jpn J Clin Oncol 2015; 46:89-95. [PMID: 26538462 DOI: 10.1093/jjco/hyv154] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 09/17/2015] [Indexed: 01/27/2023] Open
Abstract
Since the serrated neoplastic pathway has been regarded as an important pathway of colorectal carcinogenesis, few reports have been published on clinical cases of cancer derived from sessile serrated adenoma/polyp, especially on recurrence after resected sessile serrated adenoma/polyp. An elderly woman underwent endoscopic mucosal resection of a flat elevated lesion, 30 mm in diameter, in the ascending colon; the histopathological diagnosis at that time was a hyperplastic polyp, now known as sessile serrated adenoma/polyp. Five years later, cancer due to the malignant transformation of the sessile serrated adenoma/polyp was detected at the same site. The endoscopic diagnosis was a deep invasive carcinoma with a remnant sessile serrated adenoma/polyp component. The carcinoma was surgically removed, and the pathological diagnosis was an adenocarcinoma with sessile serrated adenoma/polyp, which invaded the muscularis propria. The surgically removed lesion did not have a B-RAF mutation in either the sessile serrated adenoma/polyp or the carcinoma; moreover, the initial endoscopically resected lesion also did not have a B-RAF mutation. Immunohistochemistry confirmed negative MLH1 protein expression in only the cancer cells. Lynch syndrome was not detected on genomic examination. The lesion was considered to be a cancer derived from sessile serrated adenoma/polyp recurrence after endoscopic resection, because both the surgically and endoscopically resected lesions were detected at the same location and had similar pathological characteristics, with a serrated structure and low-grade atypia. Furthermore, both lesions had a rare diagnosis of a sessile serrated adenoma/polyp without B-RAF mutation. This report highlights the need for the follow-up colonoscopy after endoscopic resection and rethinking our resection procedures to improve treatment.
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Affiliation(s)
- A Chino
- Digestive of Gastroenterology Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo
| | - S Nagayama
- Digestive of Surgery Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo
| | - H Ishikawa
- Digestive of Gastroenterology Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo
| | - K Morishige
- Digestive of Gastroenterology Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo
| | - T Kishihara
- Digestive of Gastroenterology Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo
| | - M Arai
- Clinical Genetic Oncology Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo
| | - Y Sugiura
- Pathology Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - N Motoi
- Pathology Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - N Yamamoto
- Pathology Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Y Tamegai
- Digestive of Gastroenterology Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo
| | - M Igarashi
- Digestive of Gastroenterology Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo
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Ichikawa W, Uehara K, Minamimura K, Tanaka C, Sadahiro S, Shinozaki K, Fukumoto K, Takii Y, Otsuji T, Kambara T, Gamoh M, Morita S, Ando Y, Arai M, Sugihara M, Sugiyama T, Ohashi Y, Sakata Y. 2100 Impact of UGT1A1 genotype and irinotecan exposure on outcomes in Japanese patients with advanced colorectal cancer treated by irinotecan-based regimens. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31022-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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41
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Imai E, Isaka Y, Akagi Y, Arai M, Moriyama T, Takenaka M, Kaneko T, Horio M, Ando A, Orita Y, Kaneda Y, Ueda N, Kamada T. Application of antisense oligodeoxynucleotides (ODNs) for the intervention of kidney disease. Antisense ODNs for transforming growth factor-beta-suppressed glomerulosclerosis in experimental glomerulonephritis. Contrib Nephrol 2015; 118:86-93. [PMID: 8744044 DOI: 10.1159/000425080] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- E Imai
- First Department of Medicine, Osaka University School of Medicine, Japan
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42
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Toriumi K, Miyashita M, Ichikawa T, Kobori A, Nohara I, Arai M, Obata N, Itokawa M. [JSNP Excellent Presentation Award for CINP2014]. Nihon Shinkei Seishin Yakurigaku Zasshi 2015; 35:61-62. [PMID: 26027074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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43
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Murakawa S, Yamaguchi A, Arai M, Wasai M, Aoki Y, Ishimoto H, Nomura R, Okuda Y, Nagato Y, Higashitani S, Nagai K. Spin-dependent acoustic response in the nonunitary A1 and A2 phases of superfluid 3He under high magnetic fields. Phys Rev Lett 2015; 114:105304. [PMID: 25815943 DOI: 10.1103/physrevlett.114.105304] [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: 10/14/2014] [Indexed: 06/04/2023]
Abstract
The transverse acoustic impedance of superfluid ^{3}He was measured in the A1 and A2 phases up to 13 T to investigate the surface states in nonunitary superfluids. The temperature dependence of the impedance was much larger in the A1 phase than in the A2 phase. This nonsymmetric behavior indicates that momentum exchange with walls for spin-down surface states is quite different from that for spin-up surface states. The spin-dependent response might be a reflection of an essential feature of the nonunitary states where gap amplitudes depend on spin states. Weak-coupling theories ignore any spin-dependent processes and do not account for the nonsymmetric behavior.
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Affiliation(s)
- S Murakawa
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - A Yamaguchi
- Institute for Solid State Physics, University of Tokyo, Chiba 277-8581, Japan
| | - M Arai
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - M Wasai
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - Y Aoki
- Institute for Solid State Physics, University of Tokyo, Chiba 277-8581, Japan
| | - H Ishimoto
- Institute for Solid State Physics, University of Tokyo, Chiba 277-8581, Japan
| | - R Nomura
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - Y Okuda
- Department of Physics, Tokyo Institute of Technology, Tokyo 152-8551, Japan
| | - Y Nagato
- Graduate School of Integrated Arts and Sciences, Hiroshima University, Hiroshima 739-8521, Japan
| | - S Higashitani
- Graduate School of Integrated Arts and Sciences, Hiroshima University, Hiroshima 739-8521, Japan
| | - K Nagai
- Graduate School of Integrated Arts and Sciences, Hiroshima University, Hiroshima 739-8521, Japan
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44
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Yasui S, Fujiwara K, Nakamura M, Miyamura T, Yonemitsu Y, Mikata R, Arai M, Kanda T, Imazeki F, Oda S, Yokosuka O. Virological efficacy of combination therapy with corticosteroid and nucleoside analogue for severe acute exacerbation of chronic hepatitis B. J Viral Hepat 2015; 22:94-102. [PMID: 24750410 DOI: 10.1111/jvh.12258] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 02/09/2014] [Indexed: 12/19/2022]
Abstract
The short-term prognosis of patients with severe acute exacerbation of chronic hepatitis B (CHB) leading to acute liver failure is extremely poor. We have reported the efficacy of corticosteroid in combination with nucleoside analogue in the early stages, but virological efficacy has not been documented. Our aim was to elucidate the virological efficacy of this approach. Thirteen patients defined as severe acute exacerbation of CHB by our uniform criteria were prospectively examined for virological responses to treatment. Nucleoside analogue and sufficient dose of corticosteroids were introduced as soon as possible after the diagnosis of severe disease. Of the 13 patients, 7 (54%) survived, 5 (38%) died and 1 (8%) received liver transplantation. The decline of HBV DNA was significant between the first 2 weeks (P = 0.02) and 4 weeks (P < 0.01). Mean reduction in HBV DNA during the first 2 weeks was 1.7 ± 0.9 log copies per mL in overall patients, 2.1 ± 0.8 in survived patients and 1.2 ± 0.9 in dead/transplanted patients. The decline of HBV DNA was significant between the first 2 weeks (P = 0.03) and 4 weeks (P = 0.02) in survived patients, but not in dead/transplanted patients. Our study shows that corticosteroid treatment in combination with nucleotide analogue has sufficient virological effect against severe acute exacerbation of CHB, and a rapid decline of HBV DNA is conspicuous in survived patients.
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Affiliation(s)
- S Yasui
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
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45
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Arai M, Kudo Y, Miki N. Electroencephalogram measurement from the hairy part of the scalp using polymer-based dry microneedle electrodes. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2015:3165-3168. [PMID: 26736964 DOI: 10.7567/jjap.54.06fp14] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This paper reports a successful electroencephalogram (EEG) measurement from the hairy part of the scalp using a polymer-based dry microneedle electrode. The electrode consists of 25 pillars, each of which has a sharp microneedle on the top. Hairs are collected into the gaps of the pillars and the microneedles can reach the scalp surface. Since the microneedles can penetrate through the stratum corneum, no conductive gel is necessary to acquire high quality EEG. We experimentally investigated the pillar diameters in EEG measurement from the occipital region with hairs. The fabricated electrodes successfully measured EEG without any skin preparation or conductive gel.
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46
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Arai M, Ito S, Kosaka Y, Toda M, Kuroiwa M, Okamoto H. 0597. The relation between intestinal intramucosal ph and stress hormones in pig hemorrhagic shock model. Intensive Care Med Exp 2014. [PMCID: PMC4798586 DOI: 10.1186/2197-425x-2-s1-p40] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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47
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Mendoza NS, Arai M, Kawaguchi T, Yoshida T, Joson LM. Purification and properties of mannanase from Bacillus subtilis. World J Microbiol Biotechnol 2014; 10:551-5. [DOI: 10.1007/bf00367665] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/29/1994] [Accepted: 05/03/1994] [Indexed: 11/30/2022]
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48
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Kawaguchi T, Nagae H, Murao S, Arai M. Purification and Some Properties of a Haim-sensitiveα-Amylase from Newly IsolatedBacillussp. No. 195. Biosci Biotechnol Biochem 2014; 56:1792-6. [PMID: 1369074 DOI: 10.1271/bbb.56.1792] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Newly isolated Bacillus sp. No. 195 produced an extracellular alpha-amylase sensitive to Haim which was found to inhibit specifically animal alpha-amylases. The enzyme was purified easily by two steps of starch adsorption and gel filtration using Sephacryl S-200. The purified enzyme, which showed a single band on native-PAGE or SDS-PAGE, had a molecular weight of 60,000 as judged on SDS-PAGE. The optimum pH value for activity and the isoelectric point were around 7.0 and 4.5, respectively. The sensitivity of the amylase to Haim was similar to that of animal amylase rather than bacterial amylase. It was suggested that a Haim-amylase complex might be formed at the molar ratio of 1:1. The amino acid sequence F-S-W similar to the triplet F-E-W highly conserved among alpha-amylases sensitive to proteinaceous inhibitors, such as Hoe 467-A or Haim, was found in the amino-terminal part of the No. 195 amylase.
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Affiliation(s)
- T Kawaguchi
- Department of Agricultural Chemistry, College of Agriculture, University of Osaka Prefecture, Japan
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49
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Sato T, Miyazawa K, Suzuki Y, Mizutani Y, Uchibori S, Asaoka R, Arai M, Togari A, Goto S. Selective β2-adrenergic Antagonist Butoxamine Reduces Orthodontic Tooth Movement. J Dent Res 2014; 93:807-12. [PMID: 24868013 DOI: 10.1177/0022034514536730] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2013] [Accepted: 04/26/2014] [Indexed: 12/22/2022] Open
Abstract
Recently, involvement of the sympathetic nervous system in bone metabolism has attracted attention. β2-Adrenergic receptor (β2-AR) is presented on osteoblastic and osteoclastic cells. We previously demonstrated that β-AR blockers at low dose improve osteoporosis with hyperactivity of the sympathetic nervous system via β2-AR blocking, while they may have a somewhat inhibitory effect on osteoblastic activity at high doses. In this study, the effects of butoxamine (BUT), a specific β2-AR antagonist, on tooth movement were examined in spontaneously hypertensive rats (SHR) showing osteoporosis with hyperactivity of the sympathetic nervous system. We administered BUT (1 mg/kg) orally, and closed-coil springs were inserted into the upper-left first molar. After sacrifice, we calculated the amount of tooth movement and analyzed the trabecular microarchitecture and histomorphometry. The distance in the SHR control was greater than that in the Wistar-Kyoto rat group, but no significant difference was found in the SHR treated with BUT compared with the Wistar-Kyoto rat control. Analysis of bone volume per tissue volume, trabecular number, and osteoclast surface per bone surface in the alveolar bone showed clear bone loss by an increase of bone resorption in SHR. In addition, BUT treatment resulted in a recovery of alveolar bone loss. Furthermore, TH-immunoreactive nerves in the periodontal ligament were increased by tooth movement, and BUT administration decreased TH-immunoreactive nerves. These results suggest that BUT prevents alveolar bone loss and orthodontic tooth movement via β2-AR blocking.
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Affiliation(s)
- T Sato
- Department of Orthodontics, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - K Miyazawa
- Department of Orthodontics, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Y Suzuki
- Department of Orthodontics, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - Y Mizutani
- Department of Orthodontics, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - S Uchibori
- Department of Orthodontics, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - R Asaoka
- Department of Orthodontics, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - M Arai
- Department of Pharmacology, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan Department of Dental Hygiene, Aichi-Gakuin Junior College, Nagoya, Japan
| | - A Togari
- Department of Pharmacology, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
| | - S Goto
- Department of Orthodontics, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan
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50
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Iwanaka T, Arai M, Ito M, Kawashima H, Matoba K, Imaizumi S. Challenges of laparoscopic resection of abdominal neuroblastoma with lymphadenectomy. Surg Endosc 2014; 15:489-92. [PMID: 11353967 DOI: 10.1007/s004640090014] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2000] [Accepted: 08/10/2000] [Indexed: 10/28/2022]
Abstract
BACKGROUND The laparoscopic procedure involving total resection of abdominal neuroblastoma combined with lymphadenectomy has not been reviewed in English literature. The aim of this study was to evaluate the significance and accuracy of laparoscopic resection of abdominal neuroblastoma. METHODS Since July 1997, five patients with abdominal neuroblastoma underwent laparoscopic resection combined with lymphadenectomy or sampling of the lymph nodes. The length of operation, intraoperative blood loss, resectability, and complications were retrospectively reviewed and evaluated. RESULTS Four cases were managed laparoscopically, but one case was converted to open procedure because of poor visualization around large vessels. The mean operation time was 135 min and the intraoperative blood loss 52 ml. CONCLUSIONS Good visualization of the primary tumor and large vessels is, arguably, the most important factor for successful completion of this procedure laparoscopically. Precise indicators for laparoscopic resection of abdominal neuroblastoma provide a better prognosis and a good quality of life for children with neuroblastoma.
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Affiliation(s)
- T Iwanaka
- Department of Surgery, Saitama Children's Medical Center, 2100 Magome, Iwatsuki, Saitama 339-8551, Japan.
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