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Ikeda A, Nagafuchi H, Enomoto Y, Kurosawa K, Tsuyusaki Y, Tsuji M, Goto T. The efficacy of a medium-chain triglyceride ketogenic diet for drug-resistant epilepsy with PIGA germline variant. Seizure 2023; 111:103-105. [PMID: 37572404 DOI: 10.1016/j.seizure.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/04/2023] [Accepted: 08/06/2023] [Indexed: 08/14/2023] Open
Affiliation(s)
- Azusa Ikeda
- Department of Neurology, Kanagawa Children's Medical Center, 2-138-4, Mutsukawa, Minami-ku, Yokohama, Kanagawa 232-8555, Japan.
| | - Hiroyuki Nagafuchi
- Department of Pediatric Intensive Care Medicine, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yumi Enomoto
- Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Kenji Kurosawa
- Division of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yu Tsuyusaki
- Department of Neurology, Kanagawa Children's Medical Center, 2-138-4, Mutsukawa, Minami-ku, Yokohama, Kanagawa 232-8555, Japan
| | - Megumi Tsuji
- Department of Neurology, Kanagawa Children's Medical Center, 2-138-4, Mutsukawa, Minami-ku, Yokohama, Kanagawa 232-8555, Japan
| | - Tomohide Goto
- Department of Neurology, Kanagawa Children's Medical Center, 2-138-4, Mutsukawa, Minami-ku, Yokohama, Kanagawa 232-8555, Japan
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Tsuji M, Ikeda A, Tsuyusaki Y, Iai M, Kurosawa K, Kosaki K, Goto T. Atypical clinical course in two patients with GNB1 variants who developed acute encephalopathy. Brain Dev 2023; 45:462-466. [PMID: 37453880 DOI: 10.1016/j.braindev.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 06/15/2023] [Accepted: 06/18/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION Variants in the GNB1 gene, which encodes the β1 subunit of a trimeric G protein, can cause moderate to severe psychomotor retardation. Acute encephalopathies have also been observed in patients with central nervous system abnormalities; however, severe neurological sequelae have not previously been reported. CASE PRESENTATIONS Patient 1 was a Japanese female with a de novo GNB1 variant (c.284 T > C). At 8 months old she contracted influenza A and developed generalized convulsions. In the acute phase, brain magnetic resonance imaging (MRI) findings indicated acute encephalopathy; diffuse cerebral atrophy was present 1 month later. Although multidisciplinary treatment was administered, she had severe neurological sequelae including spastic tetraplegia, severe intellectual disabilities, and refractory epilepsy. Patient 2 was a Japanese male with a de novo GNB1 variant (c.239 T > C). He experienced an unexplained respiratory arrest aged 17 years; refractory convulsions developed. Brain MRI at 1 month showed bilateral basal ganglia high intensities; at 3 months, diffuse cerebral cortex and white matter atrophy was observed. Despite multidisciplinary treatment, he developed severe spastic tetraplegia and mental regression. DISCUSSION We report two patients with GNB1 variants who had acute lesions on brain MRI and unexpected disease courses. In such patients with acute neurological deterioration, multidisciplinary treatment is required; patients should also be carefully observed for progression to acute encephalopathy.
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Affiliation(s)
- Megumi Tsuji
- Department of Neurology, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama 232-8555, Japan; Institution for Children with Profound Multiple Disabilities, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama 232-8555, Japan.
| | - Azusa Ikeda
- Department of Neurology, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama 232-8555, Japan.
| | - Yu Tsuyusaki
- Department of Neurology, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama 232-8555, Japan.
| | - Mizue Iai
- Department of Neurology, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama 232-8555, Japan; Institution for Children with Profound Multiple Disabilities, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama 232-8555, Japan.
| | - Kenji Kurosawa
- Department of Genetics, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama 232-8555, Japan.
| | - Kenjiro Kosaki
- Center for Medical Genetics, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Tomohide Goto
- Department of Neurology, Kanagawa Children's Medical Center, 2-138-4 Mutsukawa, Minami-ku, Yokohama 232-8555, Japan.
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Ikeda A, Kumaki T, Tsuyusaki Y, Tsuji M, Enomoto Y, Fujita A, Saitsu H, Matsumoto N, Kurosawa K, Goto T. Genetic and clinical features of pediatric-onset hereditary spastic paraplegia: a single-center study in Japan. Front Neurol 2023; 14:1085228. [PMID: 37251230 PMCID: PMC10213624 DOI: 10.3389/fneur.2023.1085228] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 04/28/2023] [Indexed: 05/31/2023] Open
Abstract
Background and purpose Hereditary spastic paraplegias (HSPs) are a set of heterogeneous neurodegenerative disorders characterized by bilateral lower limb spasticity. They may present from infancy onwards at any time. Although next-generation sequencing has allowed the identification of many causative genes, little is known about which genes are specifically associated with pediatric-onset variants. Methods This study retrospectively evaluated the genetic analyses, family history clinical courses, magnetic resonance imaging (MRI) findings, and electrophysiologic findings of patients diagnosed with HSP in childhood at a tertiary pediatric hospital in Japan. Genetic analyses were performed using direct sequencing, disease-associated panels, and whole-exome sequencing. Results Of the 37 patients included, 14 had a family history of HSP and 23 had a sporadic form of the disease. In 20 patients, HSP was the pure type, whereas the remaining 17 patients had complex types of HSP. Genetic data were available for 11 of the pure-type patients and 16 of those with complex types. Of these, genetic diagnoses were possible in 5 (45%) of the pure-type and 13 (81%) of the complex-type patients. SPAST variants were found in five children, KIF1A variants in four, ALS2 variants in three, SACS and L1CAM variants in two each, and an ATL1 variant in one. One child had a 10p15.3p13 duplication. Four patients with pure-type HSPs had SPAST variants and one had an ALT1 variant. The KIF1A, ALS2, SACS, and L1CAM variants and the 10p15.3p13 duplication were seen in children with complex-type HSPs, with just one complex-type patient having a SPAST variant. The identification of brain abnormalities on MRI was significantly more common among children with complex-type (11 [69%] of 16) than pure-type HSPs (one [5%] of 19) (p < 0.001). Scores on the modified Rankin Scale for Neurologic Disability were also significantly higher among children with complex-type compared with pure-type HSPs (3.5 ± 1.0 vs. 2.1 ± 0.9, p < 0.001). Conclusion Pediatric-onset HSP was found to be sporadic and genetic in a substantial proportion of patients. The causative gene patterns differed between children with pure-type and complex-type HSPs. The causative roles of SPAST and KIF1A variants in pure-type and complex-type HSPs, respectively, should be explored further.
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Affiliation(s)
- Azusa Ikeda
- Department of Neurology, Kanagawa Children’s Medical Center, Yokohama, Japan
| | - Tatsuro Kumaki
- Division of Medical Genetics, Kanagawa Children’s Medical Center, Yokohama, Japan
| | - Yu Tsuyusaki
- Department of Neurology, Kanagawa Children’s Medical Center, Yokohama, Japan
| | - Megumi Tsuji
- Department of Neurology, Kanagawa Children’s Medical Center, Yokohama, Japan
| | - Yumi Enomoto
- Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Atsushi Fujita
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hirotomo Saitsu
- Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kenji Kurosawa
- Division of Medical Genetics, Kanagawa Children’s Medical Center, Yokohama, Japan
| | - Tomohide Goto
- Department of Neurology, Kanagawa Children’s Medical Center, Yokohama, Japan
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Ikeda A, Tomiyasu M, Yamamoto A, Tsuyusaki Y, Kawai Y, Tanabe M, Tsuji M, Iai M, Aida N, Goto T. Elevation of brain gamma‐aminobutyric acid levels is associated with vigabatrin‐associated brain abnormalities on magnetic resonance imaging. Epilepsy Res 2022; 181:106881. [DOI: 10.1016/j.eplepsyres.2022.106881] [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] [Received: 11/20/2021] [Revised: 01/14/2022] [Accepted: 02/04/2022] [Indexed: 11/29/2022]
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Tsuji M, Nishi M, Tabei T, Ishikawa W, Iai M. Endoscopic lithotripsy for upper urinary tract stones in disabled adolescents. Pediatr Int 2022; 64:e14731. [PMID: 34708892 DOI: 10.1111/ped.14731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/10/2021] [Accepted: 04/07/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Megumi Tsuji
- Institution for Children with Profound Multiple Disabilities, Kanagawa Children's Medical Center, Yokohama, Japan.,Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Morihiro Nishi
- Department of Urology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Tadashi Tabei
- Department of Urology, Yokosuka Kyosai Hospital, Yokosuka, Japan
| | | | - Mizue Iai
- Institution for Children with Profound Multiple Disabilities, Kanagawa Children's Medical Center, Yokohama, Japan.,Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
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Kuroda K, Tsuji M, Saito E, Kawamura K, Ono T, Tokioka K, Kawai Y. Hyperacute postprocedural high platelet reactivity: a novel predictor for in-hospital adverse events in acute coronary syndrome with prasugrel loading. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Postprocedural High platelet reactivity (HPR) seems to associate long term adverse cardiovascular events, mainly intrastent thrombosis. However, the relationship between hyper-acute postprocedural HPR with prasugrel loading and clinical outcomes in acute coronary syndrome (ACS) is still unclear. Moreover, factors contributing HPR in ACS with prasugrel loading are also unknown.
Purpose
This study aimed to assess the impact of hyper-acute postprocedural HPR with prasugrel loading on clinical outcomes in ACS during hospitalization, as well as to define appropriate cut-off values and identify contributing factors of HPR.
Methods
We performed a single-centre, retrospective observational study that enrolled 207 patients who underwent emergent PCI for ACS with prasugrel loading. The P2Y12reaction unit (PRU) value was measured immediately after PCI with the VerifyNow System. The primary endpoint was major adverse cardiac events (MACE, defined as the composite of death, myocardial infarction, stroke, heart failure, ventricular arrhythmia needing defibrillation).
Results
Mean patient age (standard deviation) was 70.5 (±13.0) years, 78.7% were male, and average time from prasugrel intake to PRU calculation was 98.3 (±49.1) min. During a mean hospital stay of 15.9 (±9.3) days, there were 34 in-hospital MACE (16.4%) and 10 deaths (4.8%). Thrombosis events, didn't stand out and mechanical complications, such as cardiac rupture and cardiac tamponade occupies most of cardiovascular death which occurred before 10 days on admission. PRU was significantly higher in MACE group than Non-MACE group (279±65 vs 227±72, p<0.001 respectively). The ROC curve analysis of PRU for discriminating significant in-hospital MACE showed the cut off value of 293 (sensitivity:52.9%, specificity:83.2% [AUC=0.709, p<0.0001]). 47patients (29.4%) were thus categorized as HPR (PRU>293) immediately after emergent PCI. Kaplan-Meyer curve showed MACE events occurred in HPR group than non-HPR group (38.2% vs 10.0%, p<0.001). Multiple cox analysis demonstrated that HPR was independent predictors of MACE in patients with ACS underwent PCI (OR 5.416, 95% CI 2.157–13.598, p<0.0001). Multiple logistic regression model showed female sex, low haemoglobin value, and large mean platelet volume were independent predictors of HPR.
Conclusion
PRU was significantly higher in MACE group, and appropriate cut-off value of HPR in this study was 293. HPR was independent predictor of MACE during hospitalization, however thrombosis event was not significant. Evidence of clinical impact with postprocedural HPR within 120 minutes after prasugrel loading is scarce. This study shows post-procedural HPR, even without sufficient time after prasugrel intake, can be a useful predictive marker of adverse events during hospitalization.
Funding Acknowledgement
Type of funding sources: None. PRU between Non-MACE and MACE groupKaplan-Meyer curve
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Affiliation(s)
- K Kuroda
- Okayama City Hospital, Okayama, Japan
| | - M Tsuji
- Okayama City Hospital, Okayama, Japan
| | - E Saito
- Okayama City Hospital, Okayama, Japan
| | | | - T Ono
- Okayama City Hospital, Okayama, Japan
| | - K Tokioka
- Okayama City Hospital, Okayama, Japan
| | - Y Kawai
- Okayama City Hospital, Okayama, Japan
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Ono T, Miyoshi T, Ueki Y, Kuroda K, Saito E, Tsuji M, Kawamura K, Tokioka K, Ohe T, Kawai Y. Cardio-ankle vascular index is useful screening method to detect obstructive coronary artery disease in asymptomatic diabetes patients with subclinical atherosclerosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2388] [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: 11/15/2022] Open
Abstract
Abstract
Background
Patients with diabetes mellitus are at very high risk for obstructive coronary artery disease; however, invasive coronary angiography is not allowed to apply in all patients. Cardio-ankle vascular index (CAVI), a marker of arterial stiffness has been reported to reflect atherosclerotic burden.
Purpose
To assess the diagnostic performance of CAVI vs. coronary calcium score for detecting obstructive coronary artery disease determined by Coronary CT angiography (CCTA) in asymptomatic diabetes patients.
Methods
During May 2015 to December 2019, 816 patients with diabetes mellitus were evaluated. First, intima-media thickness of carotid artery was measured in all subjects. Then, patients with intima-media thickness over 11mm underwent CAVI. Finally, 209 patients who have one or more cardiovascular risk factors other than diabetes mellitus were enrolled (68±11 years, 68% men). Patients were excluded if they had a disorder of the kidney, a prior history of coronary artery revascularization, atrial fibrillation, LV ejection fraction <50%, ABI <0.9 or allergy to contrast. Diagnostic performance of CAVI was evaluated with coronary stenosis >50% by CCTA.
Results
CAVI, Agatston score, and intima-media thickness of carotid artery were 9.2±1.3, 396±621 and 2.0±0.7mm, respectively. CAVI was significantly correlated with age (r=0.530, p<0.001), coronary artery calcification (r=0.182, p=0.008), and intima-media thickness of carotid artery (r=0.195, p=0.005). Among them, 108 patients (48%) had coronary stenosis. CAVI, Agatston score and intima-media thickness of carotid artery in patients with coronary stenosis were higher than that without coronary stenosis, respectively (9.8±1.1 vs 8.5±1.0, p<0.001, 526±676 vs. 255±525, p=0.001, 2.2±0.7 vs. 1.8±0.6, p<0.001). The ROC curve analysis of CAVI for discriminating coronary stenosis showed that the sensitivity 75.0% and specificity 77.2% at the cut off value of 9.23 (AUC=0.812, p<0.001). Contrastingly, diagnostic performance of coronary calcium score and intima-media thickness of carotid artery were less than CAVI (sensitivity: 91.7%, specificity: 56.4%, AUC=0.753, p<0.05 vs. CAVI, sensitivity: 68.5%, specificity: 59.4%, AUC=0.663, p<0.05 vs. CAVI). Multivariate logistic analysis demonstrated that CAVI was significantly associated with coronary stenosis (OR=4.133, p<0.001) after adjustment of conventional risk factors, although coronary calcium score was not correlated with coronary stenosis.
Conclusion
CAVI could be informative to select patients having obstructive coronary artery disease in asymptomatic diabetes patients with thick intima-media thickness.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Ono
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
| | - T Miyoshi
- Okayama University, Department of Cardiovascular Medicine, Okayama, Japan
| | - Y Ueki
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
| | - K Kuroda
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
| | - E Saito
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
| | - M Tsuji
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
| | - K Kawamura
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
| | - K Tokioka
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
| | - T Ohe
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
| | - Y Kawai
- Okayama City Hospital, Department of Cardiovascular Medicine, Okayama, Japan
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Tsuji M, Kuroda K, Saito E, Kawamura K, Ono T, Tokioka K, Ohe T, Kawai Y. Impact of high platelet reactivity on left ventricular remodeling in patients with acute coronary syndrome. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background/Introduction
Previous studies demonstrated that high platelet reactivity (HPR) predicts future cardiovascular death and coronary events in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). However, few studies have focused on the impact of HPR on left ventricular remodeling (LVR) and each echocardiographic parameter.
Purpose
The purpose of this study was to investigate the impact of HPR in ACS patients on LVR and changes in echocardiographic volume indexes and LV ejection fraction.
Methods
This is a retrospective cohort study of prospectively collected data in a single center that enrolled patients who underwent emergency PCI for ACS including STEMI and NSTEMI with prasugrel loading. The primary outcome of the study was LVR associated with HPR. Secondary endpoints were changes in indexed LVESV, LVEDV, LVEF, E/e' and LAVI between baseline and follow-up. The P2Y12 reaction unit (PRU) value in response to prasugrel was assessed by the VerifyNow P2Y12 assay. Blood samples were collected once per procedure immediately after PCI. LVR index was calculated as the relative change in LVEDV observed at follow-up compared with baseline. LVR was defined as a relative increase in LVEDV ≥20%, measured at follow-up visit compared with the baseline value before discharge.
Results
A total of 196 ACS patients who underwent emergency PCI between January 2016 and July 2020 were enrolled in the study. The mean age of the study population was 69.9 years, and 76.0% were male. On echocardiography at follow up visit of mean duration of 7.0±4.0 months, LVR was found in 38 patients (19.4%). The optimal cutoff for PRU associated with increased LVR assessed by receiver-operating characteristic curve analysis was 245.5 (AUC: 0.656; 95% CI: 0.564 to 0.749; p=0.003). On the basis of this cutoff, HPR was found in 82 patients (42.1%) and the prevalence of LVR was significantly higher in the HPR group compared to the non-HPR group (30.5% vs. 11.4%; p=0.001). Multiple Cox regression analysis showed that HPR was an independent predictor of LVR (OR 4.22, 95% CI 1.83–9.71, p=0.001). In addition, Δ% EDV and Δ% ESV increased in the HPR group, and decreased in the non-HPR group with significant differences (5.8±32.6% vs. −8.0±26.2% in Δ% EDV; p=0.002, 2.0±37.5% vs. −13.3±33.0% in Δ% ESV; p=0.004, respectively). Δ%EF, Δ%E/e', Δ%LAVI were numerically improved in the non-HPR group compared with the HPR group, but this difference did not reach statistical significance.
Conclusion
In patients with ACS, HPR defined as PRU ≥246 immediately after emergency PCI was an independent predictor of LVR in the chronic phase.
Funding Acknowledgement
Type of funding sources: None. Predictors of the presence of LVRChanges (Δ%) of LVEDV and LVESV
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Affiliation(s)
- M Tsuji
- Okayama City Hospital, Okayama, Japan
| | - K Kuroda
- Okayama City Hospital, Okayama, Japan
| | - E Saito
- Okayama City Hospital, Okayama, Japan
| | | | - T Ono
- Okayama City Hospital, Okayama, Japan
| | - K Tokioka
- Okayama City Hospital, Okayama, Japan
| | - T Ohe
- Okayama City Hospital, Okayama, Japan
| | - Y Kawai
- Okayama City Hospital, Okayama, Japan
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Anzai R, Tsuji M, Yamashita S, Wada Y, Okamoto N, Saitsu H, Matsumoto N, Goto T. Congenital disorders of glycosylation type IIb with MOGS mutations cause early infantile epileptic encephalopathy, dysmorphic features, and hepatic dysfunction. Brain Dev 2021; 43:402-410. [PMID: 33261925 DOI: 10.1016/j.braindev.2020.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 10/11/2020] [Accepted: 10/25/2020] [Indexed: 01/05/2023]
Abstract
AIM MOGS mutations cause congenital disorders of glycosylation type IIb (CDG-IIb or GCS1-CDG). The specific manifestations caused by the mutations in this gene remain unknown. We aimed to describe the clinical features of CDG- IIb and the effectiveness of urinary oligosaccharide analysis in the diagnosis of CDG- IIb. METHODS Patient 1 was analyzed with whole-exome sequencing (WES) to identify the causative gene of intractable epilepsy and severe developmental delay. After detecting MOGS mutation in patient 1, we analyzed patients 2 and 3 who were siblings and had clinical features similar to those in patient 1. Urinary oligosaccharide analysis was performed to confirm CDG- IIb diagnosis in patient 1. The clinical features of these patients were analyzed and compared with those in eight published cases. RESULTS Our three patients presented with early infantile epileptic encephalopathy, generalized hypotonia, hepatic dysfunction and dysmorphic features. In two cases, compound heterozygous mutations in MOGS were identified by WES. Isolation and characterization of the urinary oligosaccharide was performed in one of these cases to confirm the diagnosis of CDG-IIb. Although the isoelectric focusing of transferrin (IEF-T) of serum in this patient was normal, urinary excretion of Hex4 corresponding to Glc3Man was observed by mass spectrometry. CONCLUSION This report provides clinical manifestations of CDG-IIb with MOGS mutation. CDG-IIb shows a normal IEF profile of serum transferrin and cannot be detected by structural analysis of the patient's glycoproteins. Characterization of urinary oligosaccharides should be considered to detect this disorder.
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Affiliation(s)
- Rie Anzai
- Division of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan.
| | - Megumi Tsuji
- Division of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Sumimasa Yamashita
- Division of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yoshinao Wada
- Department of Molecular Medicine, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Nobuhiko Okamoto
- Department of Molecular Medicine, Osaka Women's and Children's Hospital, Osaka, Japan; Department of Medical Genetics, Osaka Women's and Children's Hospital, Osaka, Japan
| | - Hirotomo Saitsu
- Department of Biochemistry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Tomohide Goto
- Division of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
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Beppu M, Tsuji M, Ishida F, Shirakawa M, Suzuki H, Yoshimura S. Computational Fluid Dynamics Using a Porous Media Setting Predicts Outcome after Flow-Diverter Treatment. AJNR Am J Neuroradiol 2020; 41:2107-2113. [PMID: 33004340 DOI: 10.3174/ajnr.a6766] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 07/07/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Knowledge about predictors of the outcome of flow-diverter treatment is limited. The aim of this study was to predict the angiographic occlusion status after flow-diverter treatment with computational fluid dynamics using porous media modeling for decision-making in the treatment of large wide-neck aneurysms. MATERIALS AND METHODS A total of 27 patients treated with flow-diverter stents were retrospectively analyzed through computational fluid dynamics using pretreatment patient-specific 3D rotational angiography. These patients were classified into no-filling and contrast-filling groups based on the O'Kelly-Marotta scale. The patient characteristics, morphologic variables, and hemodynamic parameters were evaluated for understanding the outcomes of the flow-diverter treatment. RESULTS The patient characteristics and morphologic variables were similar between the 2 groups. Flow velocity, wall shear stress, shear rate, modified aneurysmal inflow rate coefficient, and residual flow volume were significantly lower in the no-filling group. A novel parameter, called the normalized residual flow volume, was developed and defined as the residual flow volume normalized by the dome volume. The receiver operating characteristic curve analyses demonstrated that the normalized residual flow volume with an average flow velocity of ≥8.0 cm/s in the aneurysmal dome was the most effective in predicting the flow-diverter treatment outcomes. CONCLUSIONS It was established in this study that the hemodynamic parameters could predict the angiographic occlusion status after flow-diverter treatment.
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Affiliation(s)
- M Beppu
- From the Department of Neurosurgery (M.B., M.S., S.Y.), Hyogo College of Medicine, Hygo, Japan
| | - M Tsuji
- Department of Neurosurgery (M.T., F.I.), National Hospital Organization Mie Chuo Medical Center, Tsu, Mie, Japan
| | - F Ishida
- Department of Neurosurgery (M.T., F.I.), National Hospital Organization Mie Chuo Medical Center, Tsu, Mie, Japan
| | - M Shirakawa
- From the Department of Neurosurgery (M.B., M.S., S.Y.), Hyogo College of Medicine, Hygo, Japan
| | - H Suzuki
- Department of Neurosurgery (H.S.), Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - S Yoshimura
- From the Department of Neurosurgery (M.B., M.S., S.Y.), Hyogo College of Medicine, Hygo, Japan
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Nishimura N, Kumaki T, Murakami H, Enomoto Y, Tsurusaki Y, Tsuji M, Tsuyusaki Y, Goto T, Aida N, Kurosawa K. Expanding the phenotype of COL4A1-related disorders-Four novel variants. Brain Dev 2020; 42:639-645. [PMID: 32565002 DOI: 10.1016/j.braindev.2020.05.009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE COL4A1 variant causes severe central nervous system (CNS) anomalies, including hydranencephaly. However, the pathogenic mechanism underlying the COL4A1 phenotype remains unclear. Here, we report de novo COL4A1 variants in four Japanese patients with typical or rare CNS involvement and exhibiting diverse phenotypes. METHODS We identified and enrolled four patients with white matter abnormalities and cerebral structural defects suggestive of cerebrovascular disease. Genetic analysis was performed using panel sequencing. RESULTS All the patients were perinatally asymptomatic during the infantile period but exhibited developmental delay and growth retardation later. All the patients exhibited CNS symptoms, including psychomotor disability, spastic paralysis, and epilepsy. Brain magnetic resonance imaging revealed hydranencephaly (n = 1), ventriculomegaly (n = 4) associated with cerebral hemorrhage, and atretic encephalocele (n = 1). Three patients had developed congenital cataract, while two had hematuria. We identified two COL4A1 missense variants [exon32:c.2555G > A p.(Gly852Asp), exon40:c.3407G > A p.(Gly1136Asp)] and two in frame variants [exon32:c.2603_2609delinsATCCTGA p.(Ala868_Gly870delinsAspProGlu), exon36:c.3054delinsTGTAGAT p.(Leu1018delinsPheValAsp)]. The in frame variants were associated with severe CNS anomalies, hydranencephaly, and severe ventriculomegaly. Atretic encephalocele has never been reported in individuals with COL4A1 variants. CONCLUSIONS Our findings suggest that COL4A1 variants cause variable CNS symptoms. Association between clinical phenotypes and each COL4A1 variant would clarify their underlying etiologies.
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Affiliation(s)
- Naoto Nishimura
- Division of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Japan; Department of Pediatrics, National Defense Medical College, Tokorozawa, Japan
| | - Tatsuro Kumaki
- Division of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Japan; Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Hiroaki Murakami
- Division of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yumi Enomoto
- Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yoshinori Tsurusaki
- Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Megumi Tsuji
- Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yu Tsuyusaki
- Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Tomohide Goto
- Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Noriko Aida
- Department of Radiology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Kenji Kurosawa
- Division of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Japan.
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13
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Tsuji M, Tanaka M, Tanaka Y, Ikeda A, Tsuyusaki Y, Goto T, Iai M. Autopsy Report of a Woman with Infantile Alexander Disease Who Survived 39 Years. Neuropediatrics 2020; 51:298-301. [PMID: 32143223 DOI: 10.1055/s-0040-1705172] [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: 10/24/2022]
Abstract
Patients with infantile Alexander disease (AxD) usually do not survive beyond their early teens without life support care because of progressive central hypoventilation. We present the autopsy report of a woman with infantile AxD carrying an R239C mutation in the glial fibrillary acidic protein gene, who survived 39 years. She presented with psychomotor retardation in infancy and regressed after age 5. Brain computed tomography scans showed bilateral low frontal white matter density. She became quadriplegic with bulbar palsy and was intellectually handicapped after a measles infection at age 7. Tube feeding was introduced because of dysphagia at age 15. Noninvasive positive pressure ventilation was required due to central hypoventilation in her early thirties. She died of neurogenic respiratory failure at 39 years. Autopsy findings revealed a markedly atrophic brain (709 g, -6.0 standard deviation), especially in the frontal lobe, cerebellum, and brainstem portions. We found demyelination, gliosis, and cystic lesions throughout the brain, and we saw Rosenthal fibers accumulating in the perivascular spaces. We also identified a variety of abnormalities in other organs such as pancreatic necrosis, completely desquamated epithelium in the lower esophagus and stomach, foreign-body giant cells in the colon submucosa, glomerular sclerosis, and multiple bladder stones. This is the first autopsied case report of a patient with infantile AxD with long survival, who showed not only central nervous system characteristic findings, but also unexpected pathological changes in other organs.
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Affiliation(s)
- Megumi Tsuji
- Institution for Children with Profound Multiple Disabilities, Kanagawa Children's Medical Center, Yokohama, Japan.,Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Mio Tanaka
- Department of Pathology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yukichi Tanaka
- Department of Pathology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Azusa Ikeda
- Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yu Tsuyusaki
- Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Tomohide Goto
- Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Mizue Iai
- Institution for Children with Profound Multiple Disabilities, Kanagawa Children's Medical Center, Yokohama, Japan.,Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
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14
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Itoda Y, Kinoshita O, Yamauchi H, Shimada S, Ando M, Kimura M, Komae H, Hoshino Y, Inoue T, Tsuji M, Ono M. Efficacy of the Tricuspid Valve Intervention at the Time of Ventricular Assist Device Implantation. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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15
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Ikeda A, Yamamoto A, Ichikawa K, Tsuyusaki Y, Tsuji M, Iai M, Enomoto Y, Murakami H, Kurosawa K, Miyatake S, Matsumoto N, Goto T. Epilepsy in Christianson syndrome: Two cases of Lennox-Gastaut syndrome and a review of literature. Epilepsy Behav Rep 2019; 13:100349. [PMID: 31879735 PMCID: PMC6920258 DOI: 10.1016/j.ebr.2019.100349] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/19/2019] [Accepted: 12/01/2019] [Indexed: 10/28/2022] Open
Abstract
Christianson syndrome (CS) is an X-linked intellectual disorder caused by mutations in the SLC9A6 gene. Clinical features of CS include an inability to speak, truncal ataxia, postnatal microcephaly, hyperkinesis, and epilepsy. Almost all patients with CS develop drug-resistant epilepsy-its most serious complication. We report two cases of CS with drug-resistant epilpesy associated with the Lennox-Gastaut syndrome (LGS). One patient experienced generalized tonic seizures since 9 months of age with cognitive regression, which evolved to include atonic seizures at the age of 7 years. Electroencephalography (EEG) showed generalized slow spike-wave complexes and generalized paroxysmal fast activity. Seizures remained drug-resistant despite multiple anti-seizure drugs. The second patient experienced generalized tonic seizures since the age of 17 months and arrested development. EEG showed generalized slow spike-wave complexes, with frequent atonic seizures since the age of 6 years. Electrical status epilepticus during slow-wave sleep (ESES) developed at the age of 7 years. Our cases illustrate that CS may cause LGS in addition to other developmental and epileptic encephalopathies of the neonatal and infantile period. We suggest that generalized tonic or tonic-clonic seizures and generalized slow spike-wave complexes in interictal EEG be included as potential electroclinical features of epilepsy in CS.
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Affiliation(s)
- Azusa Ikeda
- Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Ayako Yamamoto
- Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Kazushi Ichikawa
- Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yu Tsuyusaki
- Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Megumi Tsuji
- Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Mizue Iai
- Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yumi Enomoto
- Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Hiroaki Murakami
- Division of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Kenji Kurosawa
- Division of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Satoko Miyatake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Tomohide Goto
- Department of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
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16
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Abstract
Intracranial subdural hematoma following lumbar surgery is a devastating but rare complication. It has been implicated due to intracranial hypotension secondary to persistent cerebrospinal fluid leakage. The resultant drop in intracranial pressure presumably causes traction and tearing of venous structures. Patients typically present with postural headaches. However, other symptoms of subdural hematoma, intracranial hypotension and cerebrospinal fluid leak must also be cautioned.
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Affiliation(s)
- A F Zakaria
- Department of Orthopaedic Surgery, Murayama Medical Center, Tokyo, Japan
| | - M Tsuji
- Department of Orthopaedic Surgery, Murayama Medical Center, Tokyo, Japan
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17
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Nishihara T, Shimokawahara H, Matsubara H, Hayashi K, Tsuji M, Naito T, Shigetoshi M, Tabuchi I, Ogawa A, Munemasa M. P4678The hemodynamic improvement with balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension depends on the lesion location. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1060] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Pulmonary endarterectomy (PEA) is a treatment of choice for patients with chronic thromboembolic pulmonary hypertension (CTEPH). Patients with proximal pulmonary artery disease are considered to be good candidates for PEA because of their generally excellent outcomes. However, not all patients can be operated because of patients' advanced age, comorbidities and poor general condition. Balloon pulmonary angioplasty (BPA) has become an alternative treatment for CTEPH patients especially whose lesions locate in the distal site. The effectiveness of BPA in patients who have lesions in the proximal pulmonary arteries but cannot be a candidate for PEA remains unclear.
Purpose
The aim of this study was to investigate the outcome of BPA in CTEPH patients whose lesions appears operable but ineligible for PEA.
Methods
A total of 370 patients who underwent BPA in our institute from November 2004 to January 2018 were enrolled. All the patients were divided into operable group and inoperable group according to the difference of lesion location based on the findings of perfusion scintigraphy, computed tomography and pulmonary angiography. Hemodynamic effects of BPA in both groups were investigated. We also conducted survival analyses using the Kaplan-Meier method with the log-rank test.
Results
Among 370 patients, 90 patients deemed operable. The main reasons why not operated in the PEA operable group were patient's refusal (44%), advanced age (14%), and comorbidities (27%). There were no baseline characteristic differences between two groups except for the history of acute pulmonary embolism. Mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR) equally improved after BPA in both groups (operable: 38.2±10.8 mmHg to 21.5±4.7mmHg, inoperable: 42.4±11.3 mmHg to 21.8±4.8 mmHg, p<0.001, operable: 8.0±4.2 wood unit to 3.5±1.5 wood unit, inoperable: 9.1±4.6 wood unit to 3.4±1.3 wood unit, p<0.001). Furthermore, five-year cumulative survival rates were not different between two groups (inoperable vs. operable: 93% vs. 88%, p=0.23, median follow-up period was 23.0 months (range: 5–136 months)). Meanwhile, the absolute change of mPAP and PVR in inoperable group were greater than those in operable group (inoperable: 20.7±11.2 mmHg, operable: 16.6±11.0 mmHg, p=0.010, inoperable: 5.6±4.4 wood unit, operable: 4.5±3.9 wood unit, p=0.015).
Conclusions
Although the outcome of BPA for CTEPH patients with operable lesions appears acceptable, absolute change in hemodynamics was lower than that of the patients with inoperable lesions. CTEPH with proximal lesions should be treated with PEA rather than BPA.
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Affiliation(s)
| | | | | | - K Hayashi
- Okayama Medical Center, Okayama, Japan
| | - M Tsuji
- Okayama Medical Center, Okayama, Japan
| | - T Naito
- Okayama Medical Center, Okayama, Japan
| | | | - I Tabuchi
- Okayama Medical Center, Okayama, Japan
| | - A Ogawa
- Okayama Medical Center, Okayama, Japan
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18
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Shimokawahara H, Matsubara H, Hayashi K, Tsuji M, Nishihara T, Naito T, Shigetoshi M, Tabuchi I, Munemasa M. P4675The utility of additional balloon pulmonary angioplasty for residual hypoxemia in normohemodynamic chronic thromboembolic pulmonary hypertension patients after invasive treatments. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1057] [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
Balloon pulmonary angioplasty (BPA) improves hemodynamics, symptoms and exercise capacity in patients with chronic thromboembolic pulmonary hypertension (CTEPH) who are ineligible for pulmonary endarterectomy (PEA). However, certain patients still have hypoxemia after BPA or PEA despite normalization of hemodynamics. In CTEPH, hypoxemia is related increased dead space ventilation caused by vascular obstruction.
Purpose
This study was aimed to clarify whether additional BPA can improve hypoxemia of CTEPH patients after normalization of hemodynamics.
Methods
A total of 335 patients who underwent initial series of BPA in our institute were followed up. Sixty-four patients with mean pulmonary artery pressure (mPAP) <30mmHg and percutaneous oxygen saturation (SpO2) <95% without oxygen inhalation at more than 6 months after the initial series of BPA and of patients who could reevaluate hemodynamics and oxygenation after additional BPA were enrolled. These patients were divided into two groups with or without additional BPA procedures. Change of hemodynamics and SpO2 were retrospectively investigated.
Results
Thirty-three of 64 patients underwent additional BPA procedures. Patients' age was older in BPA group than those in non-BPA group (71.3±10.4 vs. 66.5±9.4 years old, p=0.02). mPAP and pulmonary vascular resistance (PVR) was significantly higher in BPA group (mPAP: 23.9±3.2 vs. 20.7±3.8 mmHg, p=0.001, PVR: 4.2±1.2 vs. 3.5±1.4 wood unit, p=0.03, respectively). Among the 1.8±1.4 BPA procedures per person, total 6.6±3.8 segmental pulmonary arteries per person were treated. While no obvious improvements were observed in non-BPA group, PVR and SpO2 in BPA group were significantly improved (4.2±1.2 to 3.7±1.3 wood unit, p=0.002, 90.7±3.1% to 94.1±3.6%, p<0.001, respectively). In the multivariate logistic regression analysis, additional BPA procedures were associated with further improvement of SpO2 (hazard ratio, 3.7; 95% confidence interval, 1.2–11.5; P=0.02).
Conclusions
Additional BPA procedure was associated with improvement of hypoxemia in CTEPH patients after normalization of hemodynamics. Treating as many lesions as possible in BPA might relieve the patients' residual dyspnea.
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Affiliation(s)
- H Shimokawahara
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - H Matsubara
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - K Hayashi
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - M Tsuji
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - T Nishihara
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - T Naito
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - M Shigetoshi
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - I Tabuchi
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - M Munemasa
- National Hospital Organization Okayama Medical Center, Okayama, Japan
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19
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Murakami H, Kimura Y, Enomoto Y, Tsurusaki Y, Akahira-Azuma M, Kuroda Y, Tsuji M, Goto T, Kurosawa K. Discordant phenotype caused by CASK mutation in siblings with NF1. Hum Genome Var 2019; 6:20. [PMID: 31044082 PMCID: PMC6486584 DOI: 10.1038/s41439-019-0051-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 02/28/2019] [Accepted: 03/21/2019] [Indexed: 11/09/2022] Open
Abstract
With the advent of next-generation sequencing (NGS), a blended phenotype has been shown to be caused by multilocus molecular diagnosis. Here, we present siblings of neurofibromatosis type 1 (NF1) with discordant phenotypes. Further genetic investigation revealed that the younger sister had trisomy 8 mosaicism with a low ratio and a known pathogenic mutation in the CASK gene. This is the first report of a blended phenotype caused by NF1, CASK disorder, and trisomy 8 mosaicism.
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Affiliation(s)
- Hiroaki Murakami
- 1Division of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yuichi Kimura
- 2Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yumi Enomoto
- 2Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yoshinori Tsurusaki
- 2Clinical Research Institute, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Moe Akahira-Azuma
- 1Division of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yukiko Kuroda
- 1Division of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Megumi Tsuji
- 3Division of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Tomohide Goto
- 3Division of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Kenji Kurosawa
- 1Division of Medical Genetics, Kanagawa Children's Medical Center, Yokohama, Japan
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20
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Shimokawahara H, Iwano T, Nishihara T, Tsuji M, Naito T, Munemasa M, Matsubara H. P568Balloon pulmonary angioplasty for total occlusion lesions: long-term patency for total occlusion lesions depends on the flow grade at immediately after balloon pulmonary angioplasty. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Shimokawahara
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - T Iwano
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - T Nishihara
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - M Tsuji
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - T Naito
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - M Munemasa
- National Hospital Organization Okayama Medical Center, Okayama, Japan
| | - H Matsubara
- National Hospital Organization Okayama Medical Center, Okayama, Japan
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21
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Ikeda A, Tsuji M, Goto T, Iai M. Long-term home non-invasive positive pressure ventilation in children: Results from a single center in Japan. Brain Dev 2018; 40:558-565. [PMID: 29636207 DOI: 10.1016/j.braindev.2018.03.006] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 03/20/2018] [Accepted: 03/20/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND Non-invasive positive pressure ventilation (NPPV) in children has recently increased worldwide and is used not only for neuromuscular diseases but for various other diseases. However, there have been few observational studies on long-term NPPV in children in Japan. METHODS Based on medical records, we retrospectively evaluated patients aged ≤20 years who were initiated long-term NPPV at our hospital from January 2001 to December 2015. RESULTS A total of 53 patients on long-term NPPV were identified; 38 (72%) had severe motor and intellectual disabilities (SMID). Compared to those with non-neuromuscular diseases, those with neuromuscular diseases had significantly more planned initiations and less frequent use of oxygen. Regarding patient outcome, 34 patients continued NPPV (64%), and there were three discontinues (6%), seven tracheostomies (13%), and nine deaths (17%). The continuation rate was high among those with neuromuscular disorders (15/19 cases, 79%) and that of tracheotomy was high in those with metabolic/degenerative diseases (3/9 cases, 33%). Ten patients transitioned to adult care, accounting for 29% of the 34 continuing patients. CONCLUSION This is the first observational study on long-term NPPV use in children in Japan that examined outcomes in patients with a range of disorders. The initiation situation, management, and outcomes differed between patients with neuromuscular and non-neuronal muscular diseases. Long-term use of NPPV is possible in many cases, including children with SMID, but can be challenging to continue in patients with progressive diseases such as metabolic/degenerative diseases. Careful discussions regarding the management of each patient are necessary.
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Affiliation(s)
- Azusa Ikeda
- Institution for Children with Profound Multiple Disabilities, Kanagawa Children's Medical Center, Japan; Department of Neurology, Kanagawa Children's Medical Center, Japan.
| | - Megumi Tsuji
- Institution for Children with Profound Multiple Disabilities, Kanagawa Children's Medical Center, Japan; Department of Neurology, Kanagawa Children's Medical Center, Japan
| | - Tomohide Goto
- Department of Neurology, Kanagawa Children's Medical Center, Japan
| | - Mizue Iai
- Institution for Children with Profound Multiple Disabilities, Kanagawa Children's Medical Center, Japan; Department of Neurology, Kanagawa Children's Medical Center, Japan
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22
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Naito T, Shimokawahara H, Matsubara H, Iwano T, Tsuji M, Nishihara T, Tabuchi I, Shigetoshi M, Ogawa A, Munemasa M. P2615Ages are not a determinant of favorable outcome of balloon pulmonary angioplasty for chronic thromboembolic pulmonary hypertension. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- T Naito
- Okayama Medical Center, Department of cardiology, Okayama, Japan
| | - H Shimokawahara
- Okayama Medical Center, Department of cardiology, Okayama, Japan
| | - H Matsubara
- Okayama Medical Center, Department of cardiology, Okayama, Japan
| | - T Iwano
- Okayama Medical Center, Department of cardiology, Okayama, Japan
| | - M Tsuji
- Okayama Medical Center, Department of cardiology, Okayama, Japan
| | - T Nishihara
- Okayama Medical Center, Department of cardiology, Okayama, Japan
| | - I Tabuchi
- Okayama Medical Center, Department of cardiology, Okayama, Japan
| | - M Shigetoshi
- Okayama Medical Center, Department of cardiology, Okayama, Japan
| | - A Ogawa
- Okayama Medical Center, Department of cardiology, Okayama, Japan
| | - M Munemasa
- Okayama Medical Center, Department of cardiology, Okayama, Japan
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23
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Ko T, Fujita K, Nomura S, Tsuji M, Nitta D, Maki H, Hosoya Y, Amiya E, Hatano M, Ono M, Komuro I. Quantification of DNA Damage in Heart Tissue as a Novel Prediction Tool for Therapeutic Prognosis. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.578] [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] Open
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Inagaki M, Ota D, Tsuji M, Fukuuchi A. Characteristics of breast cancers due to difference in mammographic breast density. Eur J Cancer 2018. [DOI: 10.1016/s0959-8049(18)30371-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: 11/28/2022]
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25
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Nitta D, Kinugawa K, Yokota J, Endo M, Tsuji M, Saito A, Minatsuki S, Amiya E, Hatano M, Ono M, Komuro I. The Presence of Microchannel in Optical Coherence Tomography is Associated With the Plaque Volume of Cardiac Allograft Vasculopathy After Heart Transplantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.1071] [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: 11/25/2022] Open
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26
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Ichikawa K, Tsuji M, Tsuyusaki Y, Tomiyasu M, Aida N, Goto T. Serial Magnetic Resonance Imaging and 1H-Magnetic Resonance Spectroscopy in GABA Transaminase Deficiency: A Case Report. JIMD Rep 2018; 43:7-12. [PMID: 29478219 PMCID: PMC6323023 DOI: 10.1007/8904_2018_95] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 01/20/2018] [Accepted: 02/06/2018] [Indexed: 02/07/2023] Open
Abstract
Gamma-aminobutyric acid transaminase (GABA-T) deficiency is a rare, autosomal recessive disorder characterized by severe psychomotor retardation, early-onset epileptic encephalopathy, intractable seizures, hypotonia, and hyperreflexia. The disease is caused by mutation in the 4-aminobutyrate aminotransferase (ABAT) gene, which encodes an enzyme involved in GABA catabolism. In this chapter, a 10-year follow-up of GABA-T deficiency in a rare case of a long-term survivor patient is discussed. The patient showed a progression of clinical phases with increasing age. In infancy, the patient developed psychomotor retardation and recurrent encephalopathic episodes associated with febrile illness. In early childhood, the patient presented with refractory involuntary and hyperkinetic movements and dystonic hypertonicity. In childhood, the patient gradually progressed into the chronic stable phase of the condition. Magnetic resonance imaging demonstrated high signal intensity on diffusion-weighted images involving the internal and external capsules and cerebral white matter in infancy which disappeared gradually by the age of 3 years, and showed subsequently diffuse brain atrophy in childhood. Using proton magnetic resonance spectroscopy, GABA levels in the basal ganglia were shown to be markedly elevated at the age of 1-2 years, and subsequently decreased with increasing age (toward 5 years). These findings suggest that the encephalopathic episodes in infancy and clinical severity of involuntary and hyperkinetic movements may be correlated with levels of GABA in the basal ganglia. The high levels of GABA in the cerebrospinal fluid remained unaltered, whereas levels of GABA in the serum decreased during childhood. Further investigation of long-term clinical surveillance may improve the understanding of GABA-T deficiency.
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Affiliation(s)
- Kazushi Ichikawa
- Division of Neurology, Kanagawa Children's Medical Center, Yokohama, Japan.
| | - Megumi Tsuji
- Division of Neurology, Kanagawa Children’s Medical Center, Yokohama, Japan
| | - Yu Tsuyusaki
- Division of Neurology, Kanagawa Children’s Medical Center, Yokohama, Japan
| | - Moyoko Tomiyasu
- Department of Radiology, Kanagawa Children’s Medical Center, Yokohama, Japan ,Department of Molecular Imaging and Theranostics, National Institute of Radiological Sciences, Chiba, Japan ,Research Center for Child Mental Development, Chiba University, Chiba, Japan
| | - Noriko Aida
- Department of Radiology, Kanagawa Children’s Medical Center, Yokohama, Japan
| | - Tomohide Goto
- Division of Neurology, Kanagawa Children’s Medical Center, Yokohama, Japan
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Tsuji M. LONG RUN ECONOMIC EFFECT OF TELEMONITORING ON THE ELDERLY WITH CHRONIC DISEASES. Innov Aging 2017. [DOI: 10.1093/geroni/igx004.4932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- M. Tsuji
- Economics, Kobe International University, Kobe, Hyogo, Japan
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Purwadi MD, Tsuji M, Narita M, Itagaki M. A Hierarchical Domain Decomposition Boundary Element Method Applied to the Multiregion Problems of Neutron Diffusion Equations. NUCL SCI ENG 2017. [DOI: 10.13182/nse98-a1966] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- M. Dhandhang Purwadi
- Hokkaido University, Faculty of Engineering, Department of Quantum Energy Engineering Kita 13, Nishi 8, Kita-ku, Sapporo 060-0813, Japan
| | - M. Tsuji
- Hokkaido University, Faculty of Engineering, Department of Quantum Energy Engineering Kita 13, Nishi 8, Kita-ku, Sapporo 060-0813, Japan
| | - M. Narita
- Hokkaido University, Faculty of Engineering, Department of Quantum Energy Engineering Kita 13, Nishi 8, Kita-ku, Sapporo 060-0813, Japan
| | - M. Itagaki
- Hokkaido University, Faculty of Engineering, Department of Quantum Energy Engineering Kita 13, Nishi 8, Kita-ku, Sapporo 060-0813, Japan
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Koenig MK, Hodgeman R, Riviello JJ, Chung W, Bain J, Chiriboga CA, Ichikawa K, Osaka H, Tsuji M, Gibson KM, Bonnen PE, Pearl PL. Phenotype of GABA-transaminase deficiency. Neurology 2017; 88:1919-1924. [PMID: 28411234 DOI: 10.1212/wnl.0000000000003936] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 02/27/2017] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE We report a case series of 10 patients with γ-aminobutyric acid (GABA)-transaminase deficiency including a novel therapeutic trial and an expanded phenotype. METHODS Case ascertainment, literature review, comprehensive evaluations, and long-term treatment with flumazenil. RESULTS All patients presented with neonatal or early infantile-onset encephalopathy; other features were hypotonia, hypersomnolence, epilepsy, choreoathetosis, and accelerated linear growth. EEGs showed burst-suppression, modified hypsarrhythmia, multifocal spikes, and generalized spike-wave. Five of the 10 patients are currently alive with age at last follow-up between 18 months and 9.5 years. Treatment with continuous flumazenil was implemented in 2 patients. One patient, with a milder phenotype, began treatment at age 21 months and has continued for 20 months with improved alertness and less excessive adventitious movements. The second patient had a more severe phenotype and was 7 years of age at initiation of flumazenil, which was not continued. CONCLUSIONS GABA-transaminase deficiency presents with neonatal or infantile-onset encephalopathy including hypersomnolence and choreoathetosis. A widened phenotypic spectrum is reported as opposed to lethality by 2 years of age. The GABA-A benzodiazepine receptor antagonist flumazenil may represent a therapeutic strategy.
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Affiliation(s)
- Mary Kay Koenig
- From Child and Adolescent Neurology (M.K.K.), University of Texas Medical School, Houston; Neurology (R.H., P.L.P.), Boston Children's Hospital, Harvard Medical School, MA; Child Neurology (J.J.R., W.C., J.B., C.A.C.), Columbia University School of Medicine, New York, NY; Neurology (K.I., M.T.), Kanagawa Children's Medical Center, Yokohama; Pediatrics (H.O.), Jichi Medical School, Tochigi, Japan; Experimental and Systems Pharmacology (K.M.G.), Washington State University, Spokane; and Molecular and Human Genetics (P.E.B.), Baylor College of Medicine, Houston, TX
| | - Ryan Hodgeman
- From Child and Adolescent Neurology (M.K.K.), University of Texas Medical School, Houston; Neurology (R.H., P.L.P.), Boston Children's Hospital, Harvard Medical School, MA; Child Neurology (J.J.R., W.C., J.B., C.A.C.), Columbia University School of Medicine, New York, NY; Neurology (K.I., M.T.), Kanagawa Children's Medical Center, Yokohama; Pediatrics (H.O.), Jichi Medical School, Tochigi, Japan; Experimental and Systems Pharmacology (K.M.G.), Washington State University, Spokane; and Molecular and Human Genetics (P.E.B.), Baylor College of Medicine, Houston, TX
| | - James J Riviello
- From Child and Adolescent Neurology (M.K.K.), University of Texas Medical School, Houston; Neurology (R.H., P.L.P.), Boston Children's Hospital, Harvard Medical School, MA; Child Neurology (J.J.R., W.C., J.B., C.A.C.), Columbia University School of Medicine, New York, NY; Neurology (K.I., M.T.), Kanagawa Children's Medical Center, Yokohama; Pediatrics (H.O.), Jichi Medical School, Tochigi, Japan; Experimental and Systems Pharmacology (K.M.G.), Washington State University, Spokane; and Molecular and Human Genetics (P.E.B.), Baylor College of Medicine, Houston, TX
| | - Wendy Chung
- From Child and Adolescent Neurology (M.K.K.), University of Texas Medical School, Houston; Neurology (R.H., P.L.P.), Boston Children's Hospital, Harvard Medical School, MA; Child Neurology (J.J.R., W.C., J.B., C.A.C.), Columbia University School of Medicine, New York, NY; Neurology (K.I., M.T.), Kanagawa Children's Medical Center, Yokohama; Pediatrics (H.O.), Jichi Medical School, Tochigi, Japan; Experimental and Systems Pharmacology (K.M.G.), Washington State University, Spokane; and Molecular and Human Genetics (P.E.B.), Baylor College of Medicine, Houston, TX
| | - Jennifer Bain
- From Child and Adolescent Neurology (M.K.K.), University of Texas Medical School, Houston; Neurology (R.H., P.L.P.), Boston Children's Hospital, Harvard Medical School, MA; Child Neurology (J.J.R., W.C., J.B., C.A.C.), Columbia University School of Medicine, New York, NY; Neurology (K.I., M.T.), Kanagawa Children's Medical Center, Yokohama; Pediatrics (H.O.), Jichi Medical School, Tochigi, Japan; Experimental and Systems Pharmacology (K.M.G.), Washington State University, Spokane; and Molecular and Human Genetics (P.E.B.), Baylor College of Medicine, Houston, TX
| | - Claudia A Chiriboga
- From Child and Adolescent Neurology (M.K.K.), University of Texas Medical School, Houston; Neurology (R.H., P.L.P.), Boston Children's Hospital, Harvard Medical School, MA; Child Neurology (J.J.R., W.C., J.B., C.A.C.), Columbia University School of Medicine, New York, NY; Neurology (K.I., M.T.), Kanagawa Children's Medical Center, Yokohama; Pediatrics (H.O.), Jichi Medical School, Tochigi, Japan; Experimental and Systems Pharmacology (K.M.G.), Washington State University, Spokane; and Molecular and Human Genetics (P.E.B.), Baylor College of Medicine, Houston, TX
| | - Kazushi Ichikawa
- From Child and Adolescent Neurology (M.K.K.), University of Texas Medical School, Houston; Neurology (R.H., P.L.P.), Boston Children's Hospital, Harvard Medical School, MA; Child Neurology (J.J.R., W.C., J.B., C.A.C.), Columbia University School of Medicine, New York, NY; Neurology (K.I., M.T.), Kanagawa Children's Medical Center, Yokohama; Pediatrics (H.O.), Jichi Medical School, Tochigi, Japan; Experimental and Systems Pharmacology (K.M.G.), Washington State University, Spokane; and Molecular and Human Genetics (P.E.B.), Baylor College of Medicine, Houston, TX
| | - Hitoshi Osaka
- From Child and Adolescent Neurology (M.K.K.), University of Texas Medical School, Houston; Neurology (R.H., P.L.P.), Boston Children's Hospital, Harvard Medical School, MA; Child Neurology (J.J.R., W.C., J.B., C.A.C.), Columbia University School of Medicine, New York, NY; Neurology (K.I., M.T.), Kanagawa Children's Medical Center, Yokohama; Pediatrics (H.O.), Jichi Medical School, Tochigi, Japan; Experimental and Systems Pharmacology (K.M.G.), Washington State University, Spokane; and Molecular and Human Genetics (P.E.B.), Baylor College of Medicine, Houston, TX
| | - Megumi Tsuji
- From Child and Adolescent Neurology (M.K.K.), University of Texas Medical School, Houston; Neurology (R.H., P.L.P.), Boston Children's Hospital, Harvard Medical School, MA; Child Neurology (J.J.R., W.C., J.B., C.A.C.), Columbia University School of Medicine, New York, NY; Neurology (K.I., M.T.), Kanagawa Children's Medical Center, Yokohama; Pediatrics (H.O.), Jichi Medical School, Tochigi, Japan; Experimental and Systems Pharmacology (K.M.G.), Washington State University, Spokane; and Molecular and Human Genetics (P.E.B.), Baylor College of Medicine, Houston, TX
| | - K Michael Gibson
- From Child and Adolescent Neurology (M.K.K.), University of Texas Medical School, Houston; Neurology (R.H., P.L.P.), Boston Children's Hospital, Harvard Medical School, MA; Child Neurology (J.J.R., W.C., J.B., C.A.C.), Columbia University School of Medicine, New York, NY; Neurology (K.I., M.T.), Kanagawa Children's Medical Center, Yokohama; Pediatrics (H.O.), Jichi Medical School, Tochigi, Japan; Experimental and Systems Pharmacology (K.M.G.), Washington State University, Spokane; and Molecular and Human Genetics (P.E.B.), Baylor College of Medicine, Houston, TX
| | - Penelope E Bonnen
- From Child and Adolescent Neurology (M.K.K.), University of Texas Medical School, Houston; Neurology (R.H., P.L.P.), Boston Children's Hospital, Harvard Medical School, MA; Child Neurology (J.J.R., W.C., J.B., C.A.C.), Columbia University School of Medicine, New York, NY; Neurology (K.I., M.T.), Kanagawa Children's Medical Center, Yokohama; Pediatrics (H.O.), Jichi Medical School, Tochigi, Japan; Experimental and Systems Pharmacology (K.M.G.), Washington State University, Spokane; and Molecular and Human Genetics (P.E.B.), Baylor College of Medicine, Houston, TX
| | - Phillip L Pearl
- From Child and Adolescent Neurology (M.K.K.), University of Texas Medical School, Houston; Neurology (R.H., P.L.P.), Boston Children's Hospital, Harvard Medical School, MA; Child Neurology (J.J.R., W.C., J.B., C.A.C.), Columbia University School of Medicine, New York, NY; Neurology (K.I., M.T.), Kanagawa Children's Medical Center, Yokohama; Pediatrics (H.O.), Jichi Medical School, Tochigi, Japan; Experimental and Systems Pharmacology (K.M.G.), Washington State University, Spokane; and Molecular and Human Genetics (P.E.B.), Baylor College of Medicine, Houston, TX.
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Inagaki M, Ota D, Tsuji M, Nishi T, Kato T, Kobayashi Y, Mori M, Fukuuchi A. T2-weighted magnetic resonance images of triple negative breast cancer with high tumor infiltrating lymphocytes. Breast 2017. [DOI: 10.1016/s0960-9776(17)30193-5] [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: 11/26/2022] Open
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Kondo M, Tsuji M, Hara K, Arimura K, Yagi O, Tagaya E, Takeyama K, Tamaoki J. Chloride ion transport and overexpression of TMEM16A in a guinea-pig asthma model. Clin Exp Allergy 2017; 47:795-804. [PMID: 28109183 DOI: 10.1111/cea.12887] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2016] [Revised: 12/09/2016] [Accepted: 12/18/2016] [Indexed: 12/19/2022]
Abstract
BACKGROUND TMEM16A, a Ca-activated Cl channel, regulates various physiological functions such as mucin secretion. However, the role of TMEM16A in hyper-secretion in asthma is not fully understood. OBJECTIVE The aim of this study is to evaluate Cl ion transport via TMEM16A and determine the localization of TMEM16A in a guinea-pig asthma model. METHODS Guinea-pigs were sensitized with ovalbumin (OVA) i.p. on Days 1 and 8. On Day 22, we assessed OVA challenge-induced Cl ion transport in the sensitized tracheas ex vivo in an Ussing chamber, compared with the non-sensitized tracheas. We then examined the effect of T16Ainh-A01, a TMEM16A inhibitor, on the increase in Cl ion transport. The tracheal epithelium was immunostained with an anti-TMEM16A antibody. Epithelial cells from guinea-pig tracheas were cultured at the air-liquid interface in the presence of IL-13 for in vitro study. We studied the effect of TMEM16A inhibitors on Ca-dependent agonist, uridine triphosphate (UTP)-induced increases in Cl ion transport in the cultured cells. The cells were immunostained with an anti-TMEM16A antibody, an anti-MUC5AC antibody and an anti-α-tubulin antibody. RESULTS OVA challenge induced an increase in short circuit current within 1 min in the OVA-sensitized tracheas but not in the non-sensitized tracheas, which was inhibited by pretreatment of T16Ainh-A01. Sensitized tracheas showed goblet cell metaplasia with more positive TMEM16A immunostaining, particularly in the apical portion compared with the non-sensitized tracheas. The in vitro UTP-induced increase in Cl ion transport was strongly inhibited by pretreatment with T16Ainh-A01, benzbromarone, and niflumic acid. TMEM16A was positively immunostained at the apical portion and in the MUC5AC-positive area in IL-13-induced goblet cell metaplasia. CONCLUSIONS Antigen challenge and Ca-dependent agonist treatment increased Cl ion transport via the overexpression of TMEM16A in goblet cell metaplasia in a guinea-pig asthma model. TMEM16A inhibitors may be useful for the treatment of hyper-secretion in asthma.
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Affiliation(s)
- M Kondo
- First Department of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - M Tsuji
- First Department of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - K Hara
- First Department of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - K Arimura
- First Department of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - O Yagi
- First Department of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - E Tagaya
- First Department of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - K Takeyama
- First Department of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
| | - J Tamaoki
- First Department of Medicine, Tokyo Women's Medical University School of Medicine, Tokyo, Japan
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Inagaki M, Ota D, Tsuji M, Kobayashi Y, Mori M, Fukuuchi A. Abstract P4-02-04: Using ultrasound findings to predict high tumor-infiltrating lymphocytes in triple negative breast cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p4-02-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Purpose Previous clinical data showed that high tumor-infiltrating lymphocytes (TILs) indicated a good prognosis in triple negative breast cancer (TNBC) and suggested that TNBC with TILs responded well to immunotherapy. Breast ultrasound is a safe inspection method without any radiation exposure. Therefore, we investigated whether ultrasound findings can predict high TILs in TNBC.
Patients and Methods The TNBC patients who underwent surgery at Mitsui Memorial Hospital, Tokyo, Japan, from 2009 to 2015, including those who underwent neo adjuvant chemotherapy (NAC), were selected for this study. The pre-treatment ultrasound findings were used retrospectively, and we compared the shape, margin, homogeneity of internal echoes, posterior features, and growth pattern of the lesions. Regarding shape, we classified the ultrasound findings as “round”, “oval”, “lobulated”, “irregular”, and “other” in accordance with The Japan Associations of Breast and Thyroid Sonology. Similarly, we classified the margins as "circumscribed" or "well-defined and smooth", "well-defined and rough", "indistinct" and "obscure". We used “homogeneous” and “heterogeneous” internal echoes. In terms of posterior features, we used the “accentuation”, “not changing”, “attenuating” and “shadowing” categories. By referring to previous report, we classified four types of growth patterns, i.e., "growing along the mammary ducts", "expansive growth pattern", "irregularly shaped mass with retracting surrounding tissue" and "other". Two pathologists evaluated stromal TILs, which were located between the cancer nests, by surgical specimens or needle biopsies of those who underwent NAC. Then the TILs were classified into four groups: “absent”, “weak”, “moderate”, and “dense”. “Absent” indicated that there were no lymphocytes in the stroma. “Weak”, “moderate” and “dense” indicated that lymphocytes occupied about 1–40%, 40–75% and 75%–100% area in the stroma, respectively. We analyzed ultrasound findings and TILs with the χ -square test.
Results A total of 97 lesions and 95 female TNBC patients were validated. The median age was 62 years old (range, 32–88 years). Of the total, 37 patients underwent NAC. The degree of “absent” TILs was 5 lesions, “weak” was 58, “moderate” was 22, and “dense” was 12 lesions. In the ultrasound findings, the shape categories “round,” “oval,” and “lobulated” were more "dense" TILs (n=12, 100%) than others (n=47, 55.3%) (p = 0.002). The "circumscribed" and "well-defined and rough" margins were found to be more “dense” TILs (n=11, 91.7%) than the other TILs (n=49, 57.6%) (p=0.020). “Accentuating” posterior echoes were more “dense” and “moderate” TILs (n=23, 67.6%) than “weak” and “absent” TILs (n=25, 39.7%) (p=0.009). The lesions with expansively growing pattern showed higher rate “dense” and “moderate” TILs (n=20, 58.8%) than “weak” and “absent” TILs (n=20, 31.7%) (p=0.010). There were no significant differences in internal echoes.
Conclusion We determined that ultrasound findings of round, oval or lobulated shape, accentuating posterior echoes and expansively growing pattern could predict the presence of high TILs. Thus, the safe, low-cost, and radiation-free ultrasound examination was recommended for predicting high TILs and prognosis.
Citation Format: Inagaki M, Ota D, Tsuji M, Kobayashi Y, Mori M, Fukuuchi A. Using ultrasound findings to predict high tumor-infiltrating lymphocytes in triple negative breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P4-02-04.
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Affiliation(s)
- M Inagaki
- Breast and Endocrine Surgery, Mitsui Memorial Hospital, Tokyo, Japan; Pathology, Mitsui Memorial Hospital, Tokyo, Japan
| | - D Ota
- Breast and Endocrine Surgery, Mitsui Memorial Hospital, Tokyo, Japan; Pathology, Mitsui Memorial Hospital, Tokyo, Japan
| | - M Tsuji
- Breast and Endocrine Surgery, Mitsui Memorial Hospital, Tokyo, Japan; Pathology, Mitsui Memorial Hospital, Tokyo, Japan
| | - Y Kobayashi
- Breast and Endocrine Surgery, Mitsui Memorial Hospital, Tokyo, Japan; Pathology, Mitsui Memorial Hospital, Tokyo, Japan
| | - M Mori
- Breast and Endocrine Surgery, Mitsui Memorial Hospital, Tokyo, Japan; Pathology, Mitsui Memorial Hospital, Tokyo, Japan
| | - A Fukuuchi
- Breast and Endocrine Surgery, Mitsui Memorial Hospital, Tokyo, Japan; Pathology, Mitsui Memorial Hospital, Tokyo, Japan
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Taquahashi Y, Takagi A, Morita K, Tsuji M, Imaida K, Kanno J. Level of dispersion of MWCNT aerosol affects the lung burden and lung lesion in whole body inhalation study. Toxicol Lett 2016. [DOI: 10.1016/j.toxlet.2016.07.441] [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: 11/17/2022]
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Nayak D, Zhou F, Xu M, Huang J, Tsuji M, Hachem R, Mohanakumar T. Long-Term Persistence of Donor Alveolar Macrophages in Human Lung Transplant Recipients That Influences Donor-Specific Immune Responses. Am J Transplant 2016; 16:2300-11. [PMID: 27062199 PMCID: PMC5289407 DOI: 10.1111/ajt.13819] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 03/10/2016] [Accepted: 04/03/2016] [Indexed: 01/25/2023]
Abstract
Steady-state alveolar macrophages (AMs) are long-lived lung-resident macrophages with sentinel function. Evidence suggests that AM precursors originate during embryogenesis and populate lungs without replenishment by circulating leukocytes. However, their presence and persistence are unclear following human lung transplantation (LTx). Our goal was to examine donor AM longevity and evaluate whether AMs of recipient origin seed the transplanted lungs. Origin of AMs was accessed using donor-recipient HLA mismatches. We demonstrate that 94-100% of AMs present in bronchoalveolar lavage (BAL) were donor derived and, importantly, AMs of recipient origin were not detected. Further, analysis of BAL cells up to 3.5 years post-LTx revealed that the majority of AMs (>87%) was donor derived. Elicitation of de novo donor-specific antibody (DSA) is a major post-LTx complication and a risk factor for development of chronic rejection. The donor AMs responded to anti-HLA framework antibody (Ab) with secretion of inflammatory cytokines. Further, in an experimental murine model, we demonstrate that adoptive transfer of allogeneic AMs stimulated humoral and cellular immune responses to alloantigen and lung-associated self-antigens and led to bronchiolar obstruction. Therefore, donor-derived AMs play an essential role in the DSA-induced inflammatory cascade leading to obliterative airway disease of the transplanted lungs.
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Affiliation(s)
- D.K. Nayak
- Norton Thoracic Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA,Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - F. Zhou
- Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - M. Xu
- Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA
| | - J. Huang
- HIV and Malaria Vaccine Program, Aaron Diamond AIDS Research Center, Affiliate of the Rockefeller University, New York, NY, USA
| | - M. Tsuji
- HIV and Malaria Vaccine Program, Aaron Diamond AIDS Research Center, Affiliate of the Rockefeller University, New York, NY, USA
| | - R. Hachem
- Department of Medicine, Washington University School of Medicine, Saint Louis, MO, USA
| | - T. Mohanakumar
- Norton Thoracic Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA,Department of Surgery, Washington University School of Medicine, Saint Louis, MO, USA,Department of Pathology and Immunology, Washington University School of Medicine, Saint Louis, MO, USA
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Kasagi M, Fujita K, Tsuji M, Takewaki I. Automatic generation of smart earthquake-resistant building system: Hybrid system of base-isolation and building-connection. Heliyon 2016; 2:e00069. [PMID: 27441248 PMCID: PMC4945967 DOI: 10.1016/j.heliyon.2016.e00069] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 01/04/2016] [Accepted: 01/21/2016] [Indexed: 11/25/2022] Open
Abstract
A base-isolated building may sometimes exhibit an undesirable large response to a long-duration, long-period earthquake ground motion and a connected building system without base-isolation may show a large response to a near-fault (rather high-frequency) earthquake ground motion. To overcome both deficiencies, a new hybrid control system of base-isolation and building-connection is proposed and investigated. In this new hybrid building system, a base-isolated building is connected to a stiffer free wall with oil dampers. It has been demonstrated in a preliminary research that the proposed hybrid system is effective both for near-fault (rather high-frequency) and long-duration, long-period earthquake ground motions and has sufficient redundancy and robustness for a broad range of earthquake ground motions.An automatic generation algorithm of this kind of smart structures of base-isolation and building-connection hybrid systems is presented in this paper. It is shown that, while the proposed algorithm does not work well in a building without the connecting-damper system, it works well in the proposed smart hybrid system with the connecting damper system.
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Affiliation(s)
- M Kasagi
- Dept. of Architecture and Architectural Eng., Kyoto University, Nishikyo, Kyoto 615-8540, Japan
| | - K Fujita
- Dept. of Architecture and Architectural Eng., Kyoto University, Nishikyo, Kyoto 615-8540, Japan
| | - M Tsuji
- Dept. of Architecture and Architectural Eng., Kyoto University, Nishikyo, Kyoto 615-8540, Japan
| | - I Takewaki
- Dept. of Architecture and Architectural Eng., Kyoto University, Nishikyo, Kyoto 615-8540, Japan
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Tsuji M, Takahashi Y, Watabe AM, Kato F. Enhanced long-term potentiation in mature rats in a model of epileptic spasms with betamethasone-priming and postnatal N-methyl-D-aspartate administration. Epilepsia 2016; 57:495-505. [PMID: 26792416 DOI: 10.1111/epi.13315] [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] [Subscribe] [Scholar Register] [Accepted: 12/21/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Patients with epileptic spasms are at high risk for learning and memory impairment later in life. We examined whether synaptic plasticity is affected in the adult hippocampus, a structure responsible for learning and memory, using an animal model of epileptic spasms of unknown cause. METHODS We produced a rat model of N-methyl-d-aspartate (NMDA)-induced spasms combined with prenatal betamethasone administration. In 6- to 11-week-old rats, we evaluated the long-term potentiation (LTP) and general properties of synaptic transmission in pyramidal neurons in the CA1 area of the hippocampus in brain slices. RESULTS The magnitude of LTP by theta burst stimulation was significantly larger in adult rats with a history of infantile NMDA injections than in control rats and rats that received additional adrenocorticotropic hormone (ACTH) treatment. The frequency of spontaneous excitatory transmission, but not inhibitory transmission, was smaller in adult rats with a history of infantile NMDA injections. SIGNIFICANCE This study is the first to provide a basis for the alteration of synaptic plasticity and transmission in a model of epileptic spasms of unknown cause. Postnatal NMDA treatment causing epileptic spasms-like aberrant episodes in the early stage of life in rats has a latent influence on various forms of synaptic plasticity in the hippocampus. Our results provide a novel insight into cognitive impairment that appears later in life in patients with a history of epileptic spasms.
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Affiliation(s)
- Megumi Tsuji
- Department of Neuroscience, The Jikei University School of Medicine, Tokyo, Japan.,Division of Pediatric Neurology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Yukari Takahashi
- Department of Neuroscience, The Jikei University School of Medicine, Tokyo, Japan
| | - Ayako M Watabe
- Department of Neuroscience, The Jikei University School of Medicine, Tokyo, Japan.,Precursory Research for Embryonic Science and Technology (PRESTO), Japan Science and Technology Agency, Kawaguchi, Saitama, Japan
| | - Fusao Kato
- Department of Neuroscience, The Jikei University School of Medicine, Tokyo, Japan
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Huemer M, Mulder-Bleile R, Burda P, Froese DS, Suormala T, Zeev BB, Chinnery PF, Dionisi-Vici C, Dobbelaere D, Gökcay G, Demirkol M, Häberle J, Lossos A, Mengel E, Morris AA, Niezen-Koning KE, Plecko B, Parini R, Rokicki D, Schiff M, Schimmel M, Sewell AC, Sperl W, Spiekerkoetter U, Steinmann B, Taddeucci G, Trejo-Gabriel-Galán JM, Trefz F, Tsuji M, Vilaseca MA, von Kleist-Retzow JC, Walker V, Zeman J, Baumgartner MR, Fowler B. Clinical pattern, mutations and in vitro residual activity in 33 patients with severe 5, 10 methylenetetrahydrofolate reductase (MTHFR) deficiency. J Inherit Metab Dis 2016; 39:115-24. [PMID: 26025547 PMCID: PMC6551224 DOI: 10.1007/s10545-015-9860-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 04/28/2015] [Accepted: 04/29/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND Severe methylenetetrahydrofolate reductase (MTHFR) deficiency is a rare inborn defect disturbing the remethylation of homocysteine to methionine (<200 reported cases). This retrospective study evaluates clinical, biochemical genetic and in vitro enzymatic data in a cohort of 33 patients. METHODS Clinical, biochemical and treatment data was obtained from physicians by using a questionnaire. MTHFR activity was measured in primary fibroblasts; genomic DNA was extracted from cultured fibroblasts. RESULTS Thirty-three patients (mean age at follow-up 11.4 years; four deceased; median age at first presentation 5 weeks; 17 females) were included. Patients with very low (<1.5%) mean control values of enzyme activity (n = 14) presented earlier and with a pattern of feeding problems, encephalopathy, muscular hypotonia, neurocognitive impairment, apnoea, hydrocephalus, microcephaly and epilepsy. Patients with higher (>1.7-34.8%) residual enzyme activity had mainly psychiatric symptoms, mental retardation, myelopathy, ataxia and spasticity. Treatment with various combinations of betaine, methionine, folate and cobalamin improved the biochemical and clinical phenotype. During the disease course, patients with very low enzyme activity showed a progression of feeding problems, neurological symptoms, mental retardation, and psychiatric disease while in patients with higher residual enzyme activity, myelopathy, ataxia and spasticity increased. All other symptoms remained stable or improved in both groups upon treatment as did brain imaging in some cases. No clear genotype-phenotype correlation was obvious. DISCUSSION MTHFR deficiency is a severe disease primarily affecting the central nervous system. Age at presentation and clinical pattern are correlated with residual enzyme activity. Treatment alleviates biochemical abnormalities and clinical symptoms partially.
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Affiliation(s)
- Martina Huemer
- Division of Metabolism and Children's Research Center, University Childrens' Hospital Zürich, Zürich, Switzerland
- radiz - Rare Disease Initiative Zürich, Clinical Research Priority Program, University of Zürich, Zürich, Switzerland
- Department of Paediatrics, Landeskrankenhaus Bregenz, Bregenz, Austria
| | | | - Patricie Burda
- Division of Metabolism and Children's Research Center, University Childrens' Hospital Zürich, Zürich, Switzerland
| | - D Sean Froese
- Division of Metabolism and Children's Research Center, University Childrens' Hospital Zürich, Zürich, Switzerland
| | - Terttu Suormala
- Division of Metabolism and Children's Research Center, University Childrens' Hospital Zürich, Zürich, Switzerland
| | - Bruria Ben Zeev
- Edmond and Lilly Safra Pediatric Hospital, Sheba Med Center and Sackler School of Medicine Tel Aviv, Tel Aviv, Israel
| | - Patrick F Chinnery
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Carlo Dionisi-Vici
- Division of Metabolism, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Dries Dobbelaere
- Centre de Référence Maladies Héréditaires du Métabolisme de l'enfant et de l'adulte, Hôpital Jeanne de Flandre, Lille, France
| | - Gülden Gökcay
- Istanbul Medical Faculty, Children's Hospital, Pediatric Nutrition and Metabolism, Istanbul University, Istanbul, Turkey
| | - Mübeccel Demirkol
- Istanbul Medical Faculty, Children's Hospital, Pediatric Nutrition and Metabolism, Istanbul University, Istanbul, Turkey
| | - Johannes Häberle
- Division of Metabolism and Children's Research Center, University Childrens' Hospital Zürich, Zürich, Switzerland
| | - Alexander Lossos
- Villa metabolica, Center for Pediatric and Adolescent Medicine, MC Johannes-Gutenberg-University Mainz, Mainz, Germany
| | - Eugen Mengel
- Villa metabolica, Center for Pediatric and Adolescent Medicine, MC Johannes-Gutenberg-University Mainz, Mainz, Germany
| | - Andrew A Morris
- Willink Unit, Manchester Centre for Genomic Medicine, Central Manchester University Hospitals, Manchester, UK
| | - Klary E Niezen-Koning
- Laboratory Metabolic Diseases, University Medical Center Groningen, Groningen, The Netherlands
| | - Barbara Plecko
- radiz - Rare Disease Initiative Zürich, Clinical Research Priority Program, University of Zürich, Zürich, Switzerland
- Division of Child Neurology and Children's Research Center, University Children's Hospital Zürich, Zürich, Switzerland
| | - Rossella Parini
- Unit for rare metabolic diseases, Department of Pediatrics, Fondazione MBBM/San Gerardo Hospital, Monza, Italy
| | - Dariusz Rokicki
- Department of Pediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Warsaw, Poland
| | - Manuel Schiff
- Reference Center for Inborn Errors of Metabolism, Hôpital Robert Debré, APHP, INSERM U1141 and Université Paris-Diderot, Sorbonne Paris Cité, Paris, France
| | | | - Adrian C Sewell
- Department of Paediatrics, University Children's Hospital, Frankfurt am Main, Germany
- Bioscientia Institute for Laboratory Diagnostics, Ingelheim, Germany
| | - Wolfgang Sperl
- Department of Pediatrics, Paracelsus Medical University (PMU), Salzburg, Austria
| | - Ute Spiekerkoetter
- Department of General Pediatrics and Adolescent Medicine, University Children's Hospital, Freiburg, Germany
| | - Beat Steinmann
- Division of Metabolism and Children's Research Center, University Childrens' Hospital Zürich, Zürich, Switzerland
| | - Grazia Taddeucci
- Department of Pediatrics, Section of Paediatric Neurology, University of Pisa, Pisa, Italy
| | | | - Friedrich Trefz
- Department of Pediatrics, University of Heidelberg, Heidelberg, Germany
| | - Megumi Tsuji
- Department of Neuroscience, Jikei University School of Medicine, Minato, Tokyo, Japan
| | - María Antònia Vilaseca
- Laboratori de Malalties Metabòliques Hereditàrias, Hospital Sant Joan de Déu, Barcelona, Spain
| | | | - Valerie Walker
- University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jiri Zeman
- Department of Paediatrics, First Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Matthias R Baumgartner
- Division of Metabolism and Children's Research Center, University Childrens' Hospital Zürich, Zürich, Switzerland.
- radiz - Rare Disease Initiative Zürich, Clinical Research Priority Program, University of Zürich, Zürich, Switzerland.
| | - Brian Fowler
- Division of Metabolism and Children's Research Center, University Childrens' Hospital Zürich, Zürich, Switzerland.
- University Childrens' Hospital Basel (UKBB), Basel, Switzerland.
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Watabe AM, Nagase M, Hagiwara A, Hida Y, Tsuji M, Ochiai T, Kato F, Ohtsuka T. SAD-B kinase regulates pre-synaptic vesicular dynamics at hippocampal Schaffer collateral synapses and affects contextual fear memory. J Neurochem 2015; 136:36-47. [PMID: 26444684 DOI: 10.1111/jnc.13379] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [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: 07/06/2015] [Revised: 09/09/2015] [Accepted: 09/23/2015] [Indexed: 11/29/2022]
Abstract
Synapses of amphids defective (SAD)-A/B kinases control various steps in neuronal development and differentiation, such as axon specifications and maturation in central and peripheral nervous systems. At mature pre-synaptic terminals, SAD-B is associated with synaptic vesicles and the active zone cytomatrix; however, how SAD-B regulates neurotransmission and synaptic plasticity in vivo remains unclear. Thus, we used SAD-B knockout (KO) mice to study the function of this pre-synaptic kinase in the brain. We found that the paired-pulse ratio was significantly enhanced at Shaffer collateral synapses in the hippocampal CA1 region in SAD-B KO mice compared with wild-type littermates. We also found that the frequency of the miniature excitatory post-synaptic current was decreased in SAD-B KO mice. Moreover, synaptic depression following prolonged low-frequency synaptic stimulation was significantly enhanced in SAD-B KO mice. These results suggest that SAD-B kinase regulates vesicular release probability at pre-synaptic terminals and is involved in vesicular trafficking and/or regulation of the readily releasable pool size. Finally, we found that hippocampus-dependent contextual fear learning was significantly impaired in SAD-B KO mice. These observations suggest that SAD-B kinase plays pivotal roles in controlling vesicular release properties and regulating hippocampal function in the mature brain. Synapses of amphids defective (SAD)-A/B kinases control various steps in neuronal development and differentiation, but their roles in mature brains were only partially known. Here, we demonstrated, at mature pre-synaptic terminals, that SAD-B regulates vesicular release probability and synaptic plasticity. Moreover, hippocampus-dependent contextual fear learning was significantly impaired in SAD-B KO mice, suggesting that SAD-B kinase plays pivotal roles in controlling vesicular release properties and regulating hippocampal function in the mature brain.
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Affiliation(s)
- Ayako M Watabe
- Department of Neuroscience, School of Medicine, Jikei University, Tokyo, Japan.,Precursory Research for Embryonic Science and Technology (PRESTO), Japan Science and Technology Agency, Kawaguchi, Saitama, Japan
| | - Masashi Nagase
- Department of Neuroscience, School of Medicine, Jikei University, Tokyo, Japan
| | - Akari Hagiwara
- Department of Biochemistry, University of Yamanashi, Yamanashi, Japan
| | - Yamato Hida
- Department of Biochemistry, University of Yamanashi, Yamanashi, Japan
| | - Megumi Tsuji
- Department of Neuroscience, School of Medicine, Jikei University, Tokyo, Japan
| | - Toshitaka Ochiai
- Department of Neuroscience, School of Medicine, Jikei University, Tokyo, Japan
| | - Fusao Kato
- Department of Neuroscience, School of Medicine, Jikei University, Tokyo, Japan
| | - Toshihisa Ohtsuka
- Department of Biochemistry, University of Yamanashi, Yamanashi, Japan
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40
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Shimizu S, Momozawa Y, Takahashi A, Nagasawa T, Ashikawa K, Terada Y, Izumi Y, Kobayashi H, Tsuji M, Kubo M, Furuichi Y. A Genome-wide Association Study of Periodontitis in a Japanese Population. J Dent Res 2015; 94:555-61. [DOI: 10.1177/0022034515570315] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Periodontitis is a multifactorial disease in which bacterial, lifestyle, and genetic factors are involved. Although previous genetic association studies identified several susceptibility genes for periodontitis in European populations, there is little information for Asian populations. Here, we conducted a genome-wide association study and a replication study consisting of 2,760 Japanese periodontitis patients and 15,158 Japanese controls. Although single-nucleotide polymorphisms that surpassed a stringent genome-wide significance threshold ( P < 5 × 10−8) were not identified, we found 2 suggestive loci for periodontitis: KCNQ5 on chromosome 6q13 (rs9446777, P = 4.83 × 10−6, odds ratio = 0.82) and GPR141-NME8 at chromosome 7p14.1 (rs2392510, P = 4.17 × 10−6, odds ratio = 0.87). A stratified analysis indicated that the GPR141-NME8 locus had a strong genetic effect on the susceptibility to generalized periodontitis in Japanese individuals with a history of smoking. In conclusion, this study identified 2 suggestive loci for periodontitis in a Japanese population. This study should contribute to a further understanding of genetic factors for enhanced susceptibility to periodontitis.
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Affiliation(s)
- S. Shimizu
- Laboratory for Genotyping Development, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
- Department of Oral Rehabilitation, Division of Periodontology and Endodontology, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu-cho, Ishikari, Hokkaido, Japan
| | - Y. Momozawa
- Laboratory for Genotyping Development, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - A. Takahashi
- Laboratory for Statistical Analysis, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - T. Nagasawa
- Research Institute of Personalized Health Sciences, Health Sciences University of Hokkaido, Tobetsu-cho, Ishikari, Hokkaido, Japan
| | - K. Ashikawa
- Laboratory for Genotyping Development, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Y. Terada
- Division of General Dentistry, University Hospital, Health Sciences University of Hokkaido, Ainosato, Sapporo, Hokkaido, Japan
| | - Y. Izumi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - H. Kobayashi
- Department of Periodontology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - M. Tsuji
- Division of Internal Medicine, University Hospital, Health Sciences University of Hokkaido, Ainosato, Sapporo, Hokkaido, Japan
| | - M. Kubo
- Laboratory for Genotyping Development, Center for Integrative Medical Sciences, RIKEN, Yokohama, Japan
| | - Y. Furuichi
- Department of Oral Rehabilitation, Division of Periodontology and Endodontology, School of Dentistry, Health Sciences University of Hokkaido, Tobetsu-cho, Ishikari, Hokkaido, Japan
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41
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Tsuji M, Mori Y, Kanda H, Ito T, Hidaka T, Kakamu T, Kumagai T, Hayakawa T, Osaki Y, Fukushima T. Determine whether nicotine metabolism can be a key to quitting smoking. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku164.098] [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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42
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Kawakami M, Sato S, Miyabe Y, Tanabe K, Nishimura M, Tsuji M, Murakami Y, Kawabata H, Fushiki M. Development of Error Estimating Program for IMRT Dose Delivery Using Dynamic MLC Log Files. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2014.05.2476] [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: 11/30/2022]
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43
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Hosokawa K, Takami A, Tsuji M, Araoka H, Ishiwata K, Takagi S, Yamamoto H, Asano-Mori Y, Matsuno N, Uchida N, Masuoka K, Wake A, Makino S, Yoneyama A, Nakao S, Taniguchi S. Relative incidences and outcomes of Clostridium difficile infection following transplantation of unrelated cord blood, unrelated bone marrow, and related peripheral blood in adult patients: a single institute study. Transpl Infect Dis 2014; 16:412-20. [PMID: 24810244 DOI: 10.1111/tid.12224] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Revised: 01/04/2014] [Accepted: 01/09/2014] [Indexed: 01/06/2023]
Abstract
BACKGROUND Clostridium difficile is a major cause of nosocomial diarrhea. The incidence and prognosis of C. difficile-associated diarrhea (CDAD) has not yet been assessed in adult patients after unrelated cord blood transplantation (uCBT). METHODS The medical records of 135 adult unrelated cord blood transplant recipients were reviewed retrospectively to investigate the clinical features of CDAD after uCBT. These data were compared to medical records of 39 unrelated bone marrow transplant recipients and 27 related peripheral blood stem cell transplant recipients as controls. RESULTS A total of 17 recipients developed CDAD, with onset occurring at a median of 22 days (range, 0-56 days) after transplantation. Among the unrelated cord blood transplant recipients, 11 (9%) developed CDAD. These results were comparable with those of CDAD after unrelated bone marrow transplantation (uBMT) (2/39, 6%) and related peripheral blood stem cell transplantation (rPBSCT) (4/27, 16%) (P=0.37). Fifteen of the infected recipients were successfully treated with oral metronidazole, vancomycin, or cessation of antibiotics. The remaining 2 recipients who developed CDAD after uCBT died of other causes. The development of CDAD did not negatively affect overall survival after uCBT. CONCLUSIONS These data indicate that the incidence and prognosis of CDAD after uCBT are comparable with those after uBMT and rPBSCT.
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Affiliation(s)
- K Hosokawa
- Department of Hematology, Toranomon Hospital, Tokyo, Japan; Cellular Transplantation Biology, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
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44
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Nakayama S, Yokote T, Tsuji M, Hirata Y, Iwaki K, Takayama A, Nishiwaki U, Hiraoka N, Akioka T, Miyoshi T, Masuda Y, Hanafusa T. Multiple cytokine-producing testicular malignant lymphoma with clinical symptoms resembling infectious signs. Int J Immunopathol Pharmacol 2014; 27:103-7. [PMID: 24674684 DOI: 10.1177/039463201402700113] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We present the case of a 64-year-old male with painful swelling of the bilateral testes and epididymides, high fever, leukocytosis, and an elevated C-reactive protein (CRP) level. This is the first case report of testicular diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS) immunostained for multiple cytokines and their receptors, which clearly demonstrates that tumor cells express multiple cytokines [interleukin-6 (IL-6) and granulocyte colony-stimulating factor (G-CSF)] and their receptors [IL-6 receptor (IL-6R) and G-CSF receptor (G-CSFR)]. The clinical course showed that the reduction in tumor size was accompanied by a corresponding improvement in clinical symptoms and peripheral blood findings. Such clinical investigation may lead clinicians to misdiagnose inflammatory disease rather than neoplastic disease. Recognizing this paraneoplastic phenomenon associated with some cases of testicular DLBCL, NOS is important. In addition, this case suggests that the growth of tumor cells may be promoted through autocrine mechanisms of IL-6 and G-CSF, which are produced by tumor cells. The possibility that these cytokines can be produced by tumor cells and can accelerate tumor proliferation should be considered to be a cause of severe clinical symptoms, an aggressive clinical course, and an indication of the necessity of treatment. Certain cytokines may be used as tumor markers in some cases of DLBCL, NOS.
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Affiliation(s)
- S Nakayama
- Department of Internal Medicine (I), Osaka Medical College, Japan
| | - T Yokote
- Department of Internal Medicine (I), Osaka Medical College, Japan
| | - M Tsuji
- Division of Surgical Pathology, Osaka Medical College, Osaka, Japan
| | - Y Hirata
- Department of Internal Medicine (I), Osaka Medical College, Japan
| | - K Iwaki
- Department of Internal Medicine (I), Osaka Medical College, Japan
| | - A Takayama
- Department of Internal Medicine (I), Osaka Medical College, Japan
| | - U Nishiwaki
- Department of Internal Medicine (I), Osaka Medical College, Japan
| | - N Hiraoka
- Department of Internal Medicine (I), Osaka Medical College, Japan
| | - T Akioka
- Department of Internal Medicine (I), Osaka Medical College, Japan
| | - T Miyoshi
- Department of Internal Medicine (I), Osaka Medical College, Japan
| | - Y Masuda
- Department of Internal Medicine (I), Osaka Medical College, Japan
| | - T Hanafusa
- Department of Internal Medicine (I), Osaka Medical College, Japan
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Hiranaka T, Pandit H, Gill HS, Hida Y, Uemoto H, Doita M, Tsuji M, Murray DW. Medial femoral head border is a reliable and reproducible reference for axis determination for femoral component of unicompartmental knee arthroplasty. Knee Surg Sports Traumatol Arthrosc 2013; 21:2442-6. [PMID: 23052119 DOI: 10.1007/s00167-012-2227-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Accepted: 09/18/2012] [Indexed: 11/30/2022]
Abstract
PURPOSE The femoral component should be implanted parallel to the mechanical axis in unicompartmental knee arthroplasty. It was hypothesised that a line between medial femoral condyle centres and medial border of femoral head will be parallel to the mechanical axis; this study set out to examine this hypothesis. METHODS One hundred X-rays in fifty patients were included for this study. Long-leg standing X-rays including hip and ankle with patellae facing forwards were obtained. On these films, we measured the angle, α, between mechanical axis and the line between the femoral head centre and knee centre (medial mechanical axis), and the angle, β, between the medial mechanical axis and a line between medial femoral condyle and femoral head centre. RESULTS The average value of α was 0.1 ± 0.5° and the average value of β 3.0° ± 0.3°. These data indicate that mechanical axis and medial mechanical axis are virtually parallel to each other. CONCLUSION As medial femoral head border is easily identified fluoroscopically, it is a reliable landmark for orientating the femoral component of medial UKA.
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Affiliation(s)
- T Hiranaka
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Windmill Road, Headington, Oxfordshire, Oxford, OX3 7HE, UK,
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Katagiri K, Awatani J, Koyanagi K, Onishi Y, Tsuji M. Dislocation structures associated with fracture surface topographies in Stage II fatigue crack growth in copper and 70 : 30 brass. ACTA ACUST UNITED AC 2013. [DOI: 10.1179/030634580790426094] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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47
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Nakayama S, Yokote T, Hirata Y, Iwaki K, Akioka T, Miyoshi T, Takayama A, Nishiwaki U, Masuda Y, Ikemoto T, Tanaka H, Nishimura Y, Tsuji M, Hanafusa T. An approach for plasma cell myeloma diagnosis by two-color flow cytometry based on kappa/lambda ratios of CD38-gated plasma cells. Int J Immunopathol Pharmacol 2013; 26:479-83. [PMID: 23755763 DOI: 10.1177/039463201302600221] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Criteria from the World Health Organization (WHO) are commonly used to diagnose plasma cell myeloma (PCM), but they are complex and require several laboratory parameters. To differentiate reactive plasmacytosis from clonal plasma cell neoplasms, such as PCM, it is important to accurately determine the expression of the cytoplasmic immunoglobulin (cIg) light chain (LC). Through retrospective analyses, we selected the patients with PCM, and analyzed records of 52 PCM patients, who underwent bone biopsies, and final diagnosis of PCM was established according to WHO criteria, and 22 controls. In the present study, all samples were analyzed by flow cytometry (FC) in the side scatter vs CD38 histogram mode, and the CD38-gated plasma cell population was identified. The positive cell ratios of kappa and lambda to plasma cell populations were analyzed. PCM cells were distinguished from normal plasma cells by a cut-off level between 0.80 and 3.3, a sensitivity of 90.3 percent, and a specificity of 81.1 percent. Two-color FC analysis is simple to perform, inexpensive, and clinically relevant data are obtained soon after completion of the FC measurements. It could be one of the helpful tools in the diagnosis of PCM. The correct diagnosis of PCM can be achieved more simply, efficiently, and rapidly by combining this method.
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Affiliation(s)
- S Nakayama
- Department of Internal Medicine (I), Osaka Medical College, Osaka, Japan
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Mitani T, Ohtsuka Y, Yamamoto K, Watanabe Y, Tsuji M, Samejima K, Aida N, Sato T, Wada T, Osaka H. [An 8-year-old boy with anti-NMDA receptor encephalitis, successfully treated with cyclophosphamide]. No To Hattatsu 2013; 45:53-57. [PMID: 23593747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
We report on an 8-year-old boy with non-paraneoplastic anti-NMDA receptor (NMDAR) encephalitis, who presented with psychotic symptoms and involuntary movement following an intractable seizure. His serum and CSF tested positive for anti-NMDAR antibodies. He received an initial immunotherapy consisting of methylprednisolone pulse therapy (mPSL) and intravenous immunoglobulin therapy (IVIg), without any clinical improvement. He had three cycles of monthly cyclophosphamide pulse therapy (500 mg/m2), and his clinical condition started to improve gradually two weeks after the first cycle, without any side effects. Six months after onset, he tested normal upon standard neurological examination. Cyclophosphamide therapy should be considered for children with anti-NMDAR encephalitis, as well as mPSL and IVIg.
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Affiliation(s)
- Tadahiro Mitani
- Division of Neurology, Kanagawa Children's Medical Center, Yokohama, Kanagawa
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Nakayama S, Yokote T, Iwaki K, Hirata Y, Akioka T, Miyoshi T, Takayama A, Nishiwaki U, Masuda Y, Tsuji M, Hanafusa T. Co-expression of multiple cytokines and their receptors in primary clear cell sarcoma of the pubic bone with features of a small round cell tumor. Int J Immunopathol Pharmacol 2012; 25:799-804. [PMID: 23058034 DOI: 10.1177/039463201202500330] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
We present the case of an 81-year-old man with primary clear cell sarcoma (CCS) of the pubic bone with an associated aggressive clinical course. The patient's laboratory tests showed marked leukocytosis, elevated levels of C-reactive protein and multiple cytokines, including interleukin-6 (IL-6) and granulocyte colony-stimulating factor (G-CSF). Histological examination showed monomorphic small cells predominantly arranged as a diffuse sheet with morphological features of a small round cell tumor (SRCT). Immunohistochemical staining indicated that the tumor cells were positive for HMB45, S100, Melan A, IL-6, IL-6 receptor, G-CSF, and G-CSF receptor and negative for cytokeratin (AE1/AE3) and epithelial membrane antigen. To the best of our knowledge, this is the first case report of aggressive primary CCS of the pubic bone with features of SRCT showing the production and co-expression of multiple cytokines and their receptors. Thus, we suggest that proliferation through an IL-6- and G-CSF-associated autocrine mechanism may play an important role in the aggressive clinical course and poor prognosis of some CCSs showing features of SRCT.
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Affiliation(s)
- S Nakayama
- Department of Internal Medicine (I), Osaka Medical College, Osaka, Japan.
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Pathirana I, Yamasaki H, Kawate N, Tsuji M, Büllesbach E, Takahashi M, Hatoya S, Inaba T, Tamada H. Plasma insulin-like peptide 3 and testosterone concentrations in male dogs: Changes with age and effects of cryptorchidism. Theriogenology 2012; 77:550-7. [DOI: 10.1016/j.theriogenology.2011.08.030] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2011] [Revised: 08/09/2011] [Accepted: 08/24/2011] [Indexed: 11/26/2022]
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