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Kasahara M, Kanematsu S, Tanaka Y, Okazaki S, Watatani M. Clinical benefits of tomosynthesis-guided vacuum assisted breast biopsy: a comparison with stereotactic vacuum assisted biopsy. Breast Cancer 2024; 31:329-334. [PMID: 38324059 DOI: 10.1007/s12282-024-01542-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 12/30/2023] [Indexed: 02/08/2024]
Abstract
BACKGROUND Tomosynthesis-guided vacuum assisted breast biopsy (3D-VAB) has been used increasingly. The aim of our study is to compare the clinical effectiveness of 3D-VAB and stereotactic vacuum assisted biopsy (2D-VAB) on the number of tissue cores containing targeted calcifications and on the procedure time. METHODS Consecutive 87 women who underwent biopsy at our hospital from April 2020 to March 2022 for calcifications mammographically suspicious of malignancy were included in this study: 57 patients with 3D-VAB and 30 patients with 2D-VAB. RESULTS Grouped or clustered calcified lesions were found in 39 and 21 patients among the 3D-VAB group and the 2D-VAB group, respectively. The mean number of tissue cores per biopsy containing targeted calcifications from the grouped or clustered calcified lesions was 3 and 2.3 specimens for the 3D-VAB group and for the 2D-VAB group, respectively. The mean procedure time for grouped or clustered calcifications was significantly shorter in the 3D-VAB group than in the 2D-VAB group (16.5 min vs. 27.4 min, P < 0.01). Comparing the procedure time between 3D-VAB and 2D-VAB based on calcification category, 3D-VAB had significantly shorter procedure time than 2D-VAB for both category 3 and category 4 calcification. For all patients, the mean procedure time was 18.1 min for the 3D-VAB group and 27.7 min for the 2D-VAB, thus being significantly shorter with 3D-VAB than 2D-VAB (P < 0.01). CONCLUSION Our study demonstrated that the clinical effectiveness of 3D-VAB is superior to that of 2D-VAB and that the significant reduction in examination time with 3D-VAB is expected to benefit patients.
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Affiliation(s)
- Mikiko Kasahara
- Department of Surgery, Division of Breast Surgery, Kansai Medical University Kori Hospital, 8-45 Kourihondoricho, Neyagawa, Osaka, 572-8551, Japan
| | - Sayaka Kanematsu
- Department of Surgery, Division of Breast Surgery, Kansai Medical University Kori Hospital, 8-45 Kourihondoricho, Neyagawa, Osaka, 572-8551, Japan
| | - Yoshihito Tanaka
- Department of Surgery, Division of Breast Surgery, Kansai Medical University Kori Hospital, 8-45 Kourihondoricho, Neyagawa, Osaka, 572-8551, Japan
| | - Satoshi Okazaki
- Department of Surgery, Division of Breast Surgery, Kansai Medical University Kori Hospital, 8-45 Kourihondoricho, Neyagawa, Osaka, 572-8551, Japan
| | - Masahiro Watatani
- Department of Surgery, Division of Breast Surgery, Kansai Medical University Kori Hospital, 8-45 Kourihondoricho, Neyagawa, Osaka, 572-8551, Japan.
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Fujioka I, Ichikawa Y, Nakajima Y, Kasahara M, Hattori M, Nemoto T. Efficiency of leukocyte depletion filters and micro-aggregate filters following intra-operative cell salvage during cesarean delivery. Int J Obstet Anesth 2019; 41:59-64. [PMID: 31358431 DOI: 10.1016/j.ijoa.2019.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 06/07/2019] [Accepted: 07/03/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND Intra-operative cell salvage is not routinely used during cesarean delivery because it is not cost-effective for patients at low risk of hemorrhage and there are theoretical concerns about amniotic fluid embolism. Some guidelines recommend using leukocyte depletion filters to decrease the risk of amniotic fluid embolism before re-infusing salvaged blood, but these filters are not available in Japan. We compared the efficacy and safety of leukocyte depletion and micro-aggregate filters in combination with intra-operative cell salvage during cesarean delivery. METHODS Blood was collected in a Cell Saver 5 reservoir during cesarean delivery. Four samples were collected: pre-wash, post-wash, post-filtration with a leukocyte depletion filter and post-filtration with a micro-aggregate filter. Each sample was analyzed for amniotic fluid markers of zinc coproporphyrin-1 and sialyl-Tn, for fetal hemoglobin, and the sample underwent pathological examination for white blood cells and squamous cells. Post-filtration samples were compared using paired t-tests with P <0.05 indicating statistical significance. RESULTS Zinc coproporphyrin-1 and sialyl-Tn were negative at almost all sample points. Squamous cells decreased by 59.1% post-wash and 91.2% post-filtration using a leukocyte depletion filter. Leukocyte depletion filters removed 99.7% of white blood cells and were more effective in removing white blood cells than micro-aggregate filters (P=0.02). CONCLUSION Leucocyte depletion filters are more effective in removing white blood cells and squamous cells than micro-aggregate filters, and their introduction for intra-operative cell salvage during cesarean delivery should be considered in Japanese clinical practice.
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Affiliation(s)
- I Fujioka
- Department of Obstetrics and Gynecology, Japanese Red Cross Shizuoka Hospital, Japan.
| | - Y Ichikawa
- Department of Obstetrics and Gynecology, Japanese Red Cross Shizuoka Hospital, Japan
| | - Y Nakajima
- Department of Anesthesiology, Japanese Red Cross Shizuoka Hospital, Japan
| | - M Kasahara
- Department of Clinical Pathology, Japanese Red Cross Shizuoka Hospital, Japan
| | - M Hattori
- Department of Obstetrics and Gynecology, Japanese Red Cross Shizuoka Hospital, Japan
| | - T Nemoto
- Department of Obstetrics and Gynecology, Japanese Red Cross Shizuoka Hospital, Japan
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Konoshita T, Azuma S, Kasahara M, Furutani M, Kaeriyama S, Nakaya T, Yamada M, Ichikawa M, Sato S, Imagawa M, Zenimaru Y, Suzuki J, Fujii M, Makino T, Onoe T. GENETIC ASSOCIATION STUDY OF UROMODULIN AND SERUM URIC ACID CONCENTRATION AND BLOOD PRESSURE. J Hypertens 2019. [DOI: 10.1097/01.hjh.0000571132.58944.57] [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]
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Yokoi H, Osaki K, Kato Y, Toda N, Ishii A, Mori K, Mori K, Kasahara M, Mukoyama M, Yanagita M. SUN-143 MATRIX METALLOPROTEINASE-10 (MMP-10) IS A KEY MOLECULE IN ALDOSTERONE-INDUCED GLOMERULAR INJURY IN SYSTEMIC GUANYLYL CYCLASE-A KNOCKOUT MICE. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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5
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Mali V, Fukuda A, Shigeta T, Uchida H, Kanazawa H, Hirata Y, Rahayatri T, Chiaki B, Sasaki K, Kitamura M, Sakamoto S, Kasahara M. Mild to Moderate Intrapulmonary Shunting in Pediatric Liver Transplantation: Is Screening Necessary? Transplant Proc 2018; 50:3496-3500. [DOI: 10.1016/j.transproceed.2018.05.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/23/2018] [Indexed: 01/26/2023]
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6
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Takagi K, Miura K, Nakanuma S, Sakamoto S, Yamamoto H, Yagi T, Eguchi S, Ohta T, Wakai T, Ohtsuka M, Uemoto S, Kasahara M, Inomata Y. Six National University Consortium in Liver Transplant Professionals Training (SNUC-LT) Program in Japan. Transplant Proc 2018; 50:168-174. [DOI: 10.1016/j.transproceed.2017.11.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 10/09/2017] [Accepted: 11/03/2017] [Indexed: 10/18/2022]
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Mali VP, Fukuda A, Shigeta T, Uchida H, Hirata Y, Rahayatri TH, Kanazawa H, Sasaki K, de Ville de Goyet J, Kasahara M. Total internal biliary diversion during liver transplantation for type 1 progressive familial intrahepatic cholestasis: a novel approach. Pediatr Transplant 2016; 20:981-986. [PMID: 27534385 DOI: 10.1111/petr.12782] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2016] [Indexed: 12/11/2022]
Abstract
LT for PFIC type 1 is often complicated by postoperative diarrhea and recurrent graft steatosis. A 26-month-old female child with cholestatic jaundice, pruritus, diarrhea, and growth retardation revealed total bilirubin 9.1 mg/dL, gamma-glutamyl transpeptidase 64 IU/L, and TBA 295.8 μmol/L. Genetic analysis confirmed ATP8B1 defects. A LT (segment 2, 3 graft) from the heterozygous father was performed. Biliary diversion was performed by a 35-cm jejunum conduit between the graft hepatic duct and the mid-transverse colon. Stools became pigmented immediately. Follow-up at 138 days revealed resolution of jaundice and pruritus and soft-to-hard stools (6-8 daily). Radioisotope hepato-biliary scintigraphy (days 26, 68, and 139) confirmed unobstructed bile drainage into the colon (t1/2 34, 27, and 19 minutes, respectively). Contrast meal follow-through at day 62 confirmed the absence of any colo-jejuno-hepatic reflux. At 140 days, contrast follow-through via the biliary stent revealed patent jejuno-colonic anastomosis and satisfactory transit. Graft biopsy at LT, 138 days, and 9 months follow-up revealed comparable grades of macrovesicular steatosis (<20%). TIBD during LT may be a clinically effective stoma-free biliary diversion and may prevent recurrent graft steatosis following LT for PFIC type 1.
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Affiliation(s)
- V P Mali
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
| | - A Fukuda
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - T Shigeta
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - H Uchida
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - Y Hirata
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - T H Rahayatri
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - H Kanazawa
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - K Sasaki
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - J de Ville de Goyet
- Department of Surgery and Transplantation Centre, Bambino Gesù Children's Hospital, Rome, Italy.,Paediatric Surgery Chair, Università di Roma Tor Vergata, Rome, Italy
| | - M Kasahara
- Organ Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
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Kasahara M. [Kouichi Terazawa (1952-2015)]. Hokkaido Igaku Zasshi 2016; 91:5. [PMID: 27416706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Ito K, Kasahara M, Saitoh A, Honda H, Miyairi I. High rate of vaccine failure after administration of acellular pertussis vaccine pre- and post-liver transplantation in children at a children's hospital in Japan. Transpl Infect Dis 2016; 18:150-4. [PMID: 26565897 DOI: 10.1111/tid.12484] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 09/25/2015] [Accepted: 09/27/2015] [Indexed: 11/30/2022]
Abstract
We assessed the serological response to pertussis vaccines administered pre- and post-liver transplantation in 58 pediatric patients at a children's hospital in Japan. A high rate of pertussis vaccine failure was observed, 44.8% against the pertussis toxin and 69.0% against filamentous hemagglutinin, with no difference in the seropositivity rate with respect to the timing of the vaccination during the peritransplant period.
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Affiliation(s)
- K Ito
- Division of Pediatric Infectious Diseases, Department of Medical Specialties, National Center for Child Health and Development, Tokyo, Japan.,Department of Infectious Diseases, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - M Kasahara
- Division of Transplant Surgery, Department of Surgical Subspecialties, National Center for Child Health and Development, Tokyo, Japan
| | - A Saitoh
- Division of Pediatric Infectious Diseases, Department of Medical Specialties, National Center for Child Health and Development, Tokyo, Japan.,Department of Pediatrics, Niigata University Graduate School of Medical and Dental Science, Niigata, Japan
| | - H Honda
- Division of Infectious Diseases, Tokyo Metropolitan Tama General Medical Center, Tokyo, Japan
| | - I Miyairi
- Division of Pediatric Infectious Diseases, Department of Medical Specialties, National Center for Child Health and Development, Tokyo, Japan
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Kukidome H, Matsuura N, Kasahara M, Ichinohe T. Continuous postoperative pain control using a multiple-hole catheter after iliac bone grafting: comparison between ropivacaine and levobupivacaine. Int J Oral Maxillofac Surg 2015; 45:454-9. [PMID: 26546392 DOI: 10.1016/j.ijom.2015.09.010] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 07/22/2015] [Accepted: 09/14/2015] [Indexed: 10/22/2022]
Abstract
The aim of this study was to compare the analgesic effects of ropivacaine and levobupivacaine in continuous infiltration anaesthesia delivered via a multiple-hole catheter for the purpose of postoperative analgesia after iliac bone grafting. Thirty-four patients scheduled for iliac bone grafting in the maxillofacial region participated in this study. The patients were randomized to a ropivacaine group (Ropi group) and a levobupivacaine group (Levo group). After harvesting the iliac bone for grafting, a multiple-hole catheter was placed on the periosteum of the iliac bone. When surgery was completed, continuous administration was started at 4 ml/h of 0.2% ropivacaine (Ropi group) or 0.25% levobupivacaine (Levo group). Pain was evaluated in the recovery room and at 4h after surgery, as well as at 9:00 and 18:00 on postoperative days 1, 2, and 3, using a visual analogue scale. Side effects were also recorded. No significant difference in the visual analogue scale scores at rest or in motion was observed between the two groups. In addition, there were no side effects in the two groups. Both 0.2% ropivacaine and 0.25% levobupivacaine provided comparable analgesic effects in continuous infiltration anaesthesia delivered via a multiple-hole catheter after iliac bone grafting.
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Affiliation(s)
- H Kukidome
- Department of Dental Anaesthesiology, Tokyo Dental College, Chiba, Japan.
| | - N Matsuura
- Department of Dental Anaesthesiology, Tokyo Dental College, Chiba, Japan
| | - M Kasahara
- Department of Pharmacology, Tokyo Dental College, Tokyo, Japan
| | - T Ichinohe
- Department of Dental Anaesthesiology, Tokyo Dental College, Chiba, Japan
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11
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Tsuchisaka A, Kaneko S, Imaoka K, Ota M, Kishimoto K, Tomaru U, Kasahara M, Ohata C, Furumura M, Takamori S, Morita E, Hashimoto T. Presence of autoimmune regulator and absence of desmoglein 1 in a thymoma in a patient with pemphigus foliaceus. Br J Dermatol 2015; 173:268-71. [PMID: 25523433 DOI: 10.1111/bjd.13617] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- A Tsuchisaka
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, 830-0011, Fukuoka, Japan
| | - S Kaneko
- Department of Dermatology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - K Imaoka
- Department of Dermatology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - M Ota
- Department of Dermatology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - K Kishimoto
- Department of Respiratory Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - U Tomaru
- Department of Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - M Kasahara
- Department of Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan
| | - C Ohata
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, 830-0011, Fukuoka, Japan
| | - M Furumura
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, 830-0011, Fukuoka, Japan
| | - S Takamori
- Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - E Morita
- Department of Dermatology, Shimane University Faculty of Medicine, Izumo, Shimane, Japan
| | - T Hashimoto
- Department of Dermatology, Kurume University School of Medicine, and Kurume University Institute of Cutaneous Cell Biology, Kurume, 830-0011, Fukuoka, Japan
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Motomura K, Sasaki A, Hisano M, Yamaguchi K, Ito Y, Ito R, Kasahara M, Matsumoto K, Sago H. A case report of neonatal hemochromatosis treated by high-dose intravenous immunoglobulin. J Reprod Immunol 2014. [DOI: 10.1016/j.jri.2014.09.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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13
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Iida T, Kaido T, Yagi S, Hori T, Uchida Y, Jobara K, Tanaka H, Sakamoto S, Kasahara M, Ogawa K, Ogura Y, Mori A, Uemoto S. Hepatic arterial complications in adult living donor liver transplant recipients: a single-center experience of 673 cases. Clin Transplant 2014; 28:1025-30. [DOI: 10.1111/ctr.12412] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2014] [Indexed: 02/01/2023]
Affiliation(s)
- T. Iida
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery; Department of Surgery; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - T. Kaido
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery; Department of Surgery; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - S. Yagi
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery; Department of Surgery; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - T. Hori
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery; Department of Surgery; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Y. Uchida
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery; Department of Surgery; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - K. Jobara
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery; Department of Surgery; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - H. Tanaka
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery; Department of Surgery; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - S. Sakamoto
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery; Department of Surgery; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - M. Kasahara
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery; Department of Surgery; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - K. Ogawa
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery; Department of Surgery; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - Y. Ogura
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery; Department of Surgery; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - A. Mori
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery; Department of Surgery; Graduate School of Medicine; Kyoto University; Kyoto Japan
| | - S. Uemoto
- Division of Hepato-Biliary-Pancreatic and Transplant Surgery; Department of Surgery; Graduate School of Medicine; Kyoto University; Kyoto Japan
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Fukuda A, Sakamoto S, Shigeta T, Uchida H, Hamano I, Sasaki K, Kanazawa H, Loh DL, Kakee N, Nakazawa A, Kasahara M. Clinical outcomes and evaluation of the quality of life of living donors for pediatric liver transplantation: a single-center analysis of 100 donors. Transplant Proc 2014; 46:1371-6. [PMID: 24836837 DOI: 10.1016/j.transproceed.2013.12.054] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 12/16/2013] [Indexed: 01/10/2023]
Abstract
There are few reports about the quality of life (QOL) and morbidities of pediatric living donor liver transplantation (LDLT) donors. We evaluated the potential morbidities and identified the predictive factors regarding the QOL of living donors after pediatric LDLT. This cross-sectional study was a single-center analysis of 100 donors for pediatric LDLT. The severity of morbidities was assessed with the Clavien classification, the QOL was investigated with the short form-36 (SF-36), and the decision-making process regarding donation was analyzed with questionnaires. The median follow-up period was 3.8 years (range, 2.2-6.0 years). A total of 13% of the donors developed postoperative complications of Clavien grades I (7%), II (3%), and IIIA (3%). There was no grade IV morbidity or mortality. Eighty-one donors responded to the questionnaire and SF-36. The analysis of the questionnaires revealed that the donors had difficulty in the decision-making process, and suggested that it may be necessary to administer multistep informed consent. We identified unique predictive risk factors for lower SF-36 scores in the donors, which were the time to donation (more than 4 weeks) and the predonation self-oriented perception. The donors who have risk factors require enhanced pre- and post-donation psychological care.
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Affiliation(s)
- A Fukuda
- Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
| | - S Sakamoto
- Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - T Shigeta
- Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - H Uchida
- Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - I Hamano
- Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - K Sasaki
- Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - H Kanazawa
- Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - D L Loh
- Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - N Kakee
- Department of Health Policy, National Research Institute for Child Health and Development, Tokyo, Japan
| | - A Nakazawa
- Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
| | - M Kasahara
- Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
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Shigeta T, Matsuno N, Obara H, Kanazawa H, Tanaka H, Fukuda A, Sakamoto S, Kasahara M, Mizunuma H, Enosawa S. Impact of rewarming preservation by continuous machine perfusion: improved post-transplant recovery in pigs. Transplant Proc 2014; 45:1684-9. [PMID: 23769024 DOI: 10.1016/j.transproceed.2013.01.098] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 01/16/2013] [Accepted: 01/31/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Utilization of grafts from donors after cardiac death (DCD) greatly expands the organ pool. However, implementation of such a strategy requires the development of novel preservation methods to achieve recovery from changes owing to warm ischemia. METHODS To assess potential methods, porcine livers harvested after 60 minutes of warm ischemic time (WIT) were perfused and preserved under the following conditions: Group 1 (n = 3), 2-hour simple cold storage and 2-hour machine perfusion (MP) at 8°C; group 2 (n = 3), 2 hours at 25°C and MP at 25°C and group 3 (n = 3), 2-hour simple cold storage and gradual rewarming to 25°C by MP. The preserved liver grafts were transplanted orthotopically into recipients. RESULTS The aspartate aminotransferase (AST), lactate dehydrogenase (LDH), and hyaluronic acid (HA) levels in recipient blood at 2 hours after reperfusion were significantly lower among group 3: AST, 789 ± 258.8, 1203 ± 217.0, and 421 ± 55.8 IU/L; LDH, 1417 ± 671.2, 2132 ± 483.9, and 634 ± 263.9 IU/L; and HA, 1660 ± 556.5, 1463 ± 332.3, and 575 ± 239.0 ng/mL for groups 1, 2 and 3, respectively. Histologically, necrosis and swelling of hepatocytes were less severe among group 3 than groups 1 and 2. Group 3 animals showed better vital responses and started spontaneous breathing within 2 hours after reperfusion; 1 recipient survived for >24 hours, although all animals in groups 1 and 2 died within 2 to 3 hours after reperfusion. CONCLUSION Rewarming by MP preservation may facilitate recovery and resuscitation of DCD liver grafts.
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Affiliation(s)
- T Shigeta
- National Center for Child Health and Development, Transplantation Center, Division for Advanced Medical Sciences, Tokyo, Japan
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16
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Egawa H, Teramukai S, Haga H, Tanabe M, Mori A, Ikegami T, Kawagishi N, Ohdan H, Kasahara M, Umeshita K. Impact of rituximab desensitization on blood-type-incompatible adult living donor liver transplantation: a Japanese multicenter study. Am J Transplant 2014; 14:102-14. [PMID: 24279828 DOI: 10.1111/ajt.12520] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2013] [Revised: 09/24/2013] [Accepted: 09/24/2013] [Indexed: 01/25/2023]
Abstract
We evaluated the effects of rituximab prophylaxis on outcomes of ABO-blood-type-incompatible living donor liver transplantation (ABO-I LDLT) in 381 adult patients in the Japanese registry of ABO-I LDLT. Patients underwent dual or triple immunosuppression with or without B cell desensitization therapies such as plasmapheresis, splenectomy, local infusion, intravenous immunoglobulin and rituximab. Era before 2005, intensive care unit-bound status, high Model for End-Stage Liver Disease score and absence of rituximab prophylaxis were significant risk factors for overall survival and antibody-mediated rejection (AMR) in the univariate analysis. After adjustment for era effects in the multivariate analysis, only absence of rituximab prophylaxis was a significant risk factor for AMR, and there were no significant risk factors for survival. Rituximab prophylaxis significantly decreased the incidence of AMR, especially hepatic necrosis (p < 0.001). In the rituximab group, other B cell desensitization therapies had no add-on effects. Multiple or large rituximab doses significantly increased the incidence of infection, and early administration had no advantage. In conclusion, outcomes in adult ABO-I LDLT have significantly improved in the latest era coincident with the introduction of rituximab.
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Affiliation(s)
- H Egawa
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan
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17
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Goon SSH, Stamatakis EA, Adapa RM, Kasahara M, Bishop S, Wood DF, Wheeler DW, Menon DK, Gupta AK. Clinical decision-making augmented by simulation training: neural correlates demonstrated by functional imaging: a pilot study. Br J Anaesth 2013; 112:124-32. [PMID: 24065729 DOI: 10.1093/bja/aet326] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Investigation of the neuroanatomical basis of clinical decision-making, and whether this differs when students are trained via online training or simulation training, could provide valuable insight into the means by which simulation training might be beneficial. METHODS The aim of this pilot prospective parallel group cohort study was to investigate the neural correlates of clinical decision-making, and to determine if simulation as opposed to online training influences these neural correlates. Twelve third-year medical students were randomized into two groups and received simulation-based or online-based training on anaphylaxis. This was followed by functional magnetic resonance imaging scanning to detect brain activation patterns while answering multiple choice questions (MCQs) related to anaphylaxis, and unrelated non-clinical (control) questions. Performance in the MCQs, salivary cortisol levels, heart rate, and arterial pressure were also measured. RESULTS Comparing neural responses to clinical and non-clinical questions (in all participants), significant areas of activation were seen in the ventral anterior cingulate cortex and medial prefrontal cortex. These areas were activated in the online group when answering action-based questions related to their training, but not in the simulation group. The simulation group tended to react more quickly and accurately to clinical MCQs than the online group, but statistical significance was not reached. CONCLUSIONS The activation areas seen could indicate increased stress when answering clinical questions compared with general non-clinical questions, and in the online group when answering action-based clinical questions. These findings suggest simulation training attenuates neural responses related to stress when making clinical decisions.
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Affiliation(s)
- S S H Goon
- University Division of Anaesthesia, Addenbrooke's Hospital, Hills Road, Cambridge CB2 0QQ, UK
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18
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Yasuno S, Ueshima K, Tanaka S, Fujimoto A, Kasahara M, Nakao Y, Ogihara T, Saruta T, Nakao K. Type 2 diabetes and a history of coronary heart disease are additive cardiovascular risks in high-risk hypertensive patients: a subanalysis of the CASE-J Ex. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.p1559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kasahara M, Umeshita K, Inomata Y, Uemoto S. Long-term outcomes of pediatric living donor liver transplantation in Japan: an analysis of more than 2200 cases listed in the registry of the Japanese Liver Transplantation Society. Am J Transplant 2013; 13:1830-9. [PMID: 23711238 DOI: 10.1111/ajt.12276] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 03/10/2013] [Accepted: 03/29/2013] [Indexed: 01/25/2023]
Abstract
The Japanese Liver Transplantation Society (JLTS) was established in 1980 in order to characterize and follow trends in patient characteristics and graft survival among all liver transplant patients in Japan. This study analyzed the comprehensive factors that may influence the outcomes of pediatric patients who undergo living donor liver transplantation (LDLT) by evaluating the largest cohort in the world. Between November 1989 and December 2010, 2224 pediatric patients underwent LDLT in Japan. There were 998 male (44.9%) and 1226 female donors (55.1%) without donor mortalities related to transplant surgery. There were 946 male (42.5%) and 1278 female (57.5%) recipients with a median age of 4.0 years (range: 13 days to 17.9 years). Cholestatic liver disease was the leading indication for LDLT (n = 1649; 76.2%), followed by metabolic disorders (n = 194; 8.7%), acute liver failure (n = 192; 8.6%) and neoplastic liver disease (n = 66; 3.0%). The 1-, 5-, 10- and 20-year patient survival rates were 88.3%, 85.4%, 82.8% and 79.6%, respectively. Blood-type incompatibility, recipient age, etiology of liver disease and transplant era were found to be significant predictors of overall survival. We are able to achieve satisfactory long-term pediatric patient survival outcomes in the JLTS series without compromising the living donors.
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Affiliation(s)
- M Kasahara
- Transplantation Center, National Center for Child Health and Development, Tokyo, Japan.
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20
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Shigeta T, Hsu HC, Enosawa S, Matsuno N, Kasahara M, Matsunari H, Umeyama K, Watanabe M, Nagashima H. Transgenic pig expressing the red fluorescent protein kusabira-orange as a novel tool for preclinical studies on hepatocyte transplantation. Transplant Proc 2013; 45:1808-10. [PMID: 23769049 DOI: 10.1016/j.transproceed.2013.01.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 01/15/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Research on hepatocyte transplantation as an alternative or supplementary treatment for liver transplantation is progressing. However, to advance to clinical trials, confidence in the technique must be established and its safety must be validated by conducting experiments using animals of comparable sizes to humans, such as pigs. We used transgenic pigs expressing red fluorescence protein for investigating the distribution and survival of transplanted cells. MATERIALS AND METHODS Donor hepatocytes were isolated from transgenic Kusabira-Orange (KO)-expressing pigs (age, 41 days; weight, 10 kg) created by in vitro fertilization using sperm from a transgenic-cloned KO pig by Matsunari et al. and ova from a domestic pig. The hepatocyte transplant recipients were the nontransgenic, KO-negative littermates. In these recipient pigs, double lumen cannulae were inserted into the supramesenteric veins to access the hepatic portal region. KO-positive donor hepatocytes from the transgenic male pig were isolated using collagenase perfusion. Hepatocytes (1 × 10(9) cells) were transplanted through the cannula. For estimating allogeneic immunogenicity, full-thickness skin (3 × 3 cm) from the same donor was grafted orthotopically on the neck region of the recipients. Immunosuppressive treatment was not implemented. The recipient pigs were humanely killed at 7 and 39 days after transplantation, and the organs were harvested, including the lungs, heart, liver, pancreas, and kidneys. RESULTS Strong red fluorescence was detected in both the parenchymal and nonparenchymal hepatocytes of the transgenic male donor pig by fluorescent microscopy. Transplanted cells were detected in the liver and lung of the recipient pigs at 7 days after perfusion. Hepatocytes remained in the liver and lung of recipients on day 39, with lower numbers than that on day 7. CONCLUSION Transgenic pigs expressing the fluorescent protein KO serve as a useful model of cell transplantation in preclinical studies.
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Affiliation(s)
- T Shigeta
- Transplantation Center, National Center for Child Health and Development, Tokyo, Japan
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21
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Abstract
While there has been increasing support for the existence of cerebral sex differences, the mechanisms underlying these differences are unclear. Based on animal data, it has long been believed that sexual differentiation of the brain is primarily linked to organizational effects of fetal testosterone. This view is, however, in question as more recent data show the presence of sex differences before the onset of testosterone production. The present study focuses on the impact that sex chromosomes might have on these differences. Utilizing the inherent differences in sex and X-chromosome dosage among XXY males, XY males, and XX females, comparative voxel-based morphometry was conducted using sex hormones and sex chromosomes as covariates. Sex differences in the cerebellar and precentral gray matter volumes (GMV) were found to be related to X-chromosome dosage, whereas sex differences in the amygdala, the parahippocamus, and the occipital cortex were linked to testosterone levels. An increased number of sex chromosomes was associated with reduced GMV in the amygdala, caudate, and the temporal and insular cortices, with increased parietal GMV and reduced frontotemporal white matter volume. No selective, testosterone independent, effect of the Y-chromosome was detected. Based on these observations, it was hypothesized that programming of the motor cortex and parts of cerebellum is mediated by processes linked to X-escapee genes, which do not have Y-chromosome homologs, and that programming of certain limbic structures involves testosterone and X-chromosome escapee genes with Y-homologs.
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Affiliation(s)
- E Lentini
- Department of Women and Child Health
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Kuwabara T, Mori K, Mukoyama M, Kasahara M, Yokoi H, Saito Y, Ogawa Y, Imamaki H, Kawanishi T, Ishii A, Koga K, Mori KP, Kato Y, Sugawara A, Nakao K. Exacerbation of diabetic nephropathy by hyperlipidaemia is mediated by Toll-like receptor 4 in mice. Diabetologia 2012; 55:2256-66. [PMID: 22610400 DOI: 10.1007/s00125-012-2578-1] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 04/04/2012] [Indexed: 12/24/2022]
Abstract
AIMS/HYPOTHESIS Hyperlipidaemia is an independent risk factor for the progression of diabetic nephropathy, but its molecular mechanism remains elusive. We investigated in mice how diabetes and hyperlipidaemia cause renal lesions separately and in combination, and the involvement of Toll-like receptor 4 (TLR4) in the process. METHODS Diabetes was induced in wild-type (WT) and Tlr4 knockout (KO) mice by intraperitoneal injection of streptozotocin (STZ). At 2 weeks after STZ injection, normal diet was substituted with a high-fat diet (HFD). Functional and histological analyses were carried out 6 weeks later. RESULTS Compared with treatment with STZ or HFD alone, treatment of WT mice with both STZ and HFD markedly aggravated nephropathy, as indicated by an increase in albuminuria, mesangial expansion, infiltration of macrophages and upregulation of pro-inflammatory and extracellular-matrix-associated gene expression in glomeruli. In Tlr4 KO mice, the addition of an HFD to STZ had almost no effects on the variables measured. Production of protein S100 calcium binding protein A8 (calgranulin A; S100A8), a potent ligand for TLR4, was observed in abundance in macrophages infiltrating STZ-HFD WT glomeruli and in glomeruli of diabetic nephropathy patients. High-glucose and fatty acid treatment synergistically upregulated S100a8 gene expression in macrophages from WT mice, but not from KO mice. As putative downstream targets of TLR4, phosphorylation of interferon regulatory factor 3 (IRF3) was enhanced in kidneys of WT mice co-treated with STZ and HFD. CONCLUSIONS/INTERPRETATION Activation of S100A8/TLR4 signalling was elucidated in an animal model of diabetic glomerular injury accompanied with hyperlipidaemia, which may provide novel therapeutic targets in progressive diabetic nephropathy.
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Affiliation(s)
- T Kuwabara
- Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawaharacho, Sakyoku, Kyoto, 606-8507, Japan
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Shigeta T, Matsuno N, Obara H, Mizunuma H, Kanazawa H, Tanaka H, Fukuda A, Sakamoto S, Kasahara M, Uemoto S, Enosawa S. Functional Recovery of Donation After Cardiac Death Liver Graft by Continuous Machine Perfusion Preservation in Pigs. Transplant Proc 2012; 44:946-7. [DOI: 10.1016/j.transproceed.2012.01.078] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Shoda T, Nomura I, Futamura M, Horimukai K, Narita M, Ohya Y, Sakamoto S, Kasahara M. The Acquisition of Food Allergy in Children after Liver Transplantation. J Allergy Clin Immunol 2012. [DOI: 10.1016/j.jaci.2011.12.791] [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: 11/30/2022]
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Shimizu H, Migita O, Kosaki R, Kasahara M, Fukuda A, Sakamoto S, Shigeta T, Uemoto S, Nakazawa A, Kakiuchi T, Arai K. Living-related liver transplantation for siblings with progressive familial intrahepatic cholestasis 2, with novel genetic findings. Am J Transplant 2011; 11:394-8. [PMID: 21219577 DOI: 10.1111/j.1600-6143.2010.03397.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Progressive familial intrahepatic cholestasis is a syndrome of severe cholestasis progressing to biliary cirrhosis and liver failure that develops in childhood. This report describes two siblings with PFIC-2 who underwent living-related liver transplantation from their genetically proven heterozygous parents. Both patients had normal gamma-glutamyl transpeptidase levels, but showed severe pruritus with sleep disturbance, cholestasis, jaundice and growth failure. Genetic testing of each patient revealed two missense mutations of the bile salt export pump, S901R and C1083Y, which have not previously been associated with PFIC-2. Usual medical treatment failed to improve their clinical symptoms, and the two siblings underwent living-related liver transplantation from their heterozygous parents. The transplants improved their clinical symptoms significantly, and the patients have since shown age-appropriate growth. Electron microscopic findings of the explanted liver of the younger sister revealed dense and amorphous bile, which is characteristic of PFIC-2. In the cases presented here, living-related liver transplantation from a heterozygous donor was associated with better quality of life and improvement of growth, and thus appears to be a feasible option for PFIC-2 patients. Mutation analysis is a useful tool to help decide the course of treatment of PFIC.
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Affiliation(s)
- H Shimizu
- Department of Gastroenterology, National Center for Child Health and Development, Tokyo, Japan.
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26
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Shigeta T, Imadome K, Sakamoto S, Fukuda A, Kakiuchi T, Matsuno N, Tanaka H, Nakazawa A, Kasahara M. Epstein-Barr Virus Infection after Pediatric Living-Related Liver Transplantation—Management and Risk Factors. Transplant Proc 2010; 42:4178-80. [DOI: 10.1016/j.transproceed.2010.09.134] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 09/29/2010] [Indexed: 11/15/2022]
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27
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Hori T, Egawa H, Takada Y, Oike F, Kasahara M, Ogura Y, Sakamoto S, Ogawa K, Yonekawa Y, Nguyen JH, Doi H, Ueno M, Uemoto S. Long-term outcomes after living-donor liver transplantation for Alagille syndrome: a single center 20-year experience in Japan. Am J Transplant 2010; 10:1951-2. [PMID: 20659101 DOI: 10.1111/j.1600-6143.2010.03196.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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28
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Kasahara M, Menon DK, Salmond CH, Outtrim JG, Taylor Tavares JV, Carpenter TA, Pickard JD, Sahakian BJ, Stamatakis EA. Altered functional connectivity in the motor network after traumatic brain injury. Neurology 2010; 75:168-76. [PMID: 20625170 DOI: 10.1212/wnl.0b013e3181e7ca58] [Citation(s) in RCA: 88] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND A large proportion of survivors of traumatic brain injury (TBI) have persistent cognitive impairments, the profile of which does not always correspond to the size and location of injuries. One possible explanation could be that TBI-induced damage extends beyond obvious lesion sites to affect remote brain networks. We explored this hypothesis in the context of a simple and well-characterized network, the motor network. The aim of this cross-sectional study was to establish the residual integrity of the motor network as an important proof of principle of abnormal connectivity in TBI. METHODS fMRI data were obtained from 12 right-handed patients and 9 healthy controls while they performed the finger-thumb opposition task with the right hand. We used both conventional and psychophysiologic interaction (PPI) analyses to examine the integrity of functional connections from brain regions we found to be activated in the paradigm we used. RESULTS As expected, the analysis showed significant activations of the left primary motor cortex (M1), right cerebellum (Ce), and bilateral supplementary motor area (SMA) in controls. However, only the activation of M1 survived robust statistical thresholding in patients. In controls, the PPI analysis revealed that left M1, SMA, and right Ce positively interacted with the left frontal cortex and negatively interacted with the right supramarginal gyrus. In patients, we observed no negative interaction and reduced interhemispheric interactions from these seed regions. CONCLUSIONS These observations suggest that patients display compromised activation and connectivity patterns during the finger-thumb opposition task, which may imply functional reorganization of motor networks following TBI.
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Affiliation(s)
- M Kasahara
- Division of Anaesthesia, University Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK.
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Kasahara M, Menon DK, Salmond CH, Outtrim JG, Tavares JVT, Carpenter TA, Sahakian BJ, Stamatakis EA. Restructuring of functional connectivity in motor network after traumatic brain injury (TBI). Neuroimage 2009. [DOI: 10.1016/s1053-8119(09)70395-7] [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: 10/20/2022] Open
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30
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Ueda M, Oike F, Kasahara M, Ogura Y, Ogawa K, Haga H, Takada Y, Egawa H, Tanaka K, Uemoto S. Portal vein complications in pediatric living donor liver transplantation using left-side grafts. Am J Transplant 2008; 8:2097-105. [PMID: 18727696 DOI: 10.1111/j.1600-6143.2008.02360.x] [Citation(s) in RCA: 96] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The aim of this report is to assess the rate of portal vein complications (PVCs), the success rate of treatment for PVCs and the prognosis of patients with PVCs for pediatric living donor liver transplantation (LDLT). Pre- and postoperative records of 521 pediatric LDLTs, using left-side grafts were retrospectively reviewed. The overall rate of PVC was 9%, with early PVC occurring in nine patients (1.7%) with a mortality rate of 67% and late PVC in 38 patients (7.3%). Fifteen of these patients with late PVC showed complete portal vein occlusion despite various treatments, and in six of them the graft was lost. Histological examination revealed fibrosis in portal areas in 13 patients, around the central veins associated with cholestasis in the parenchyma in 10, and hepatocyte ballooning in 12. Correction of portal vein flow or retransplantation is necessary for the rescue of patients with early PVCs. Graft loss in the long term may be high with the occurrence of liver failure or portal hypertension related causes, such as hepatopulmonary syndrome and gastrointestinal bleeding in patients with late PVCs. For the rescue of these patients, especially for patients with body weight < 6 kg, regular monitoring of portal vein flow is essential.
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Affiliation(s)
- M Ueda
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
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31
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Nagae T, Mori K, Mukoyama M, Kasahara M, Yokoi H, Suganami T, Sawai K, Yoshioka T, Koshikawa M, Saito Y, Ogawa Y, Kuwabara T, Tanaka I, Sugawara A, Kuwahara T, Nakao K. Adrenomedullin inhibits connective tissue growth factor expression, extracellular signal-regulated kinase activation and renal fibrosis. Kidney Int 2008; 74:70-80. [DOI: 10.1038/ki.2008.98] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Yokoi H, Mukoyama M, Mori K, Kasahara M, Suganami T, Sawai K, Yoshioka T, Saito Y, Ogawa Y, Kuwabara T, Sugawara A, Nakao K. Overexpression of connective tissue growth factor in podocytes worsens diabetic nephropathy in mice. Kidney Int 2007; 73:446-55. [PMID: 18075496 DOI: 10.1038/sj.ki.5002722] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Connective tissue growth factor (CTGF) is a potent inducer of extracellular matrix accumulation. In diabetic nephropathy, CTGF expression is markedly upregulated both in podocytes and mesangial cells, and this may play an important role in its pathogenesis. We established podocyte-specific CTGF-transgenic mice, which were indistinguishable at baseline from their wild-type littermates. Twelve weeks after streptozotocin-induced diabetes, these transgenic mice showed a more severe proteinuria, mesangial expansion, and a decrease in matrix metalloproteinase-2 activity compared to diabetic wild-type mice. Furthermore, diabetic transgenic mice exhibited less podocin expression and a decreased number of diffusely vacuolated podocytes compared to diabetic wild-type mice. Importantly, induction of diabetes in CTGF-transgenic mice resulted in a further elevation of endogenous CTGF mRNA expression and protein in the glomerular mesangium. Our findings suggest that overexpression of CTGF in podocytes is sufficient to exacerbate proteinuria and mesangial expansion through a functional impairment and loss of podocytes.
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Affiliation(s)
- H Yokoi
- Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Morioka D, Kasahara M, Horikawa R, Yokoyama S, Fukuda A, Nakagawa A. Efficacy of living donor liver transplantation for patients with methylmalonic acidemia. Am J Transplant 2007; 7:2782-7. [PMID: 17908273 DOI: 10.1111/j.1600-6143.2007.01986.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Application of liver transplantation to methylmalonic acidemia (MMAemia) is controversial because MMAemia is caused by a systemic defect of methylmalonyl-CoA mutase. The clinical courses of seven pediatric patients with MMAemia undergoing living donor liver transplantation (LDLT) were reviewed. Serum and urinary methylmalonic acid (MMA) levels were found to be significantly decreased after LDLT, whereas serum and urinary MMA levels did not return to normal in any patient. One patient died of sepsis 44 days after LDLT. The other six patients are currently doing well. All patients had preoperative history of acute metabolic decompensation and/or metabolic stroke. However, no episode of acute metabolic decompensation or metabolic stroke was observed postoperatively in any surviving patients. In the preoperative period, all patients showed lethargy and cognitive deficit, both of which were eradicated after LDLT in all surviving patients. Preoperatively, all patients were subjected to dietary protein intake restriction and tube feeding, and were administered several metabolism-correcting medications. The metabolism-correcting medications being administered remained mostly unchanged after LDLT, whereas protein restriction was liberalized and tube feeding became unnecessary in all surviving patients. In addition, physical and neurodevelopmental growth delay remained in all surviving patients during the observation period, which ranged from 4 to 21 months with a median of 10.5 months.
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Affiliation(s)
- D Morioka
- Department of Transplant Surgery, National Center for Child Health and Development, Tokyo, Japan.
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Kasahara M, Groenink L, Breuer M, Olivier B, Sarnyai Z. Altered behavioural adaptation in mice with neural corticotrophin-releasing factor overexpression. Genes Brain Behav 2007; 6:598-607. [PMID: 17147700 DOI: 10.1111/j.1601-183x.2006.00286.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Overproduction of corticotrophin-releasing factor (CRF), the major mediator of the stress response, has been linked to anxiety, depression and addiction. CRF excess results in increased arousal, anxiety and altered cognition in rodents. The ability to adapt to a potentially threatening stimulus is crucial for survival, and impaired adaptation may underlie stress-related psychiatric disorders. Therefore, we examined the effects of chronic transgenic neural CRF overproduction on behavioural adaptation to repeated exposure to a non-home cage environment. We report that CRF transgenic mice show impaired adaptation in locomotor response to the novel open field. In contrast to wild-type (WT) mice, anxiety-related behaviour of CRF transgenic mice does not change during repeated exposure to the same environment over the period of 7 days or at retest 1 week later. We found that locomotor response to novelty correlates significantly with total locomotor activity and activity in the centre at the last day of testing and at retest in WT but not in CRF transgenic mice. Mice were divided into low responders and high responders on the basis of their initial locomotor response to novelty. We found that differences in habituation and re-exposure response are related to individual differences in locomotor response to novelty. In summary, these results show that CRF transgenic mice are fundamentally different from WT in their ability to adapt to an environmental stressor. This may be related to individual differences in stress reactivity. These findings have implications for our understanding of the role of CRF overproduction in behavioural maladaptation and stress-related psychiatric disorders.
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Affiliation(s)
- M Kasahara
- Department of Pharmacology, University of Cambridge, Cambridge, United Kingdom
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Kobayashi H, Kasahara M, Hino M, Takahara S, Ikeda K, Son C, Iwakura T, Matsuoka N, Yoshimoto A, Ohgo N, Kasai R, Ishihara T, Ogawa Y. A novel heterozygous splice-site mutation of LEM domain-containing 3 in a Japanese kindred with Buschke-Ollendorff syndrome. J Endocrinol Invest 2007; 30:263-5. [PMID: 17505164 DOI: 10.1007/bf03347437] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Ashizawa T, Matsuno N, Yokoyama T, Kihara Y, Kuzuoka K, Taira S, Konno O, Jyojima Y, Akashi I, Nakamura Y, Hama K, Iwamoto H, Iwahori T, Nagao T, Kasahara M, Tanaka K. The Role of Plasmapheresis Therapy for Perioperative Management in ABO-Incompatible Adult Living Donor Liver Transplantation. Transplant Proc 2006; 38:3629-32. [PMID: 17175351 DOI: 10.1016/j.transproceed.2006.10.122] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2006] [Indexed: 11/17/2022]
Abstract
BACKGROUND Although living donor liver transplantation (LDLT) was established as a treatment for end-stage liver disease in Japan, the indication for LDLT across an ABO-incompatible barrier remains controversial. The purpose of this study was to elucidate the role of plasmapheresis in incompatible LDLT. METHODS Eleven adult patients (seven men and four women) who underwent incompatible LDLT were enrolled in this study. Of these three patients had hepatocellular carcinoma, three chronic hepatitis C, one Wilson's disease, one autoimmune hepatitis, one chronic hepatitis B, one hemochromatosis, and one fulminant hepatic failure. The immunosuppressive regimen consisted of tacrolimus, prednisolone, mycophenolate mofetil (or cyclophosphamide), and prostaglandin E1 in all patients. Multiple plasmapheresis was performed perioperatively to reduce the recipient's antibody titers against the donor's blood type. RESULTS Plasmapheresis was useful for the reduction of the recipient's antibody titers to x 16 or lower before and after transplantation. There was no difference in transplant outcome between the 11 patients with incompatible blood group and 30 patients with identical or compatible blood groups. DISCUSSION Major postoperative complications such as intrahepatic biliary complications and hepatic necrosis may occur in incompatible transplantation. Several investigators suggested that anti-immunoglobulin (Ig) M and anti-IgG antibody titers sustained these complications. The antibody titers must be decreased sufficiently with plasmapheresis. An elevation of anti-ABO titers after transplantation may be a predictive risk factor for increased mortality and morbidity. In order to perform LDLT in a safer manner, plasmapheresis is an indispensable treatment to improve the outcome of ABO-incompatible cases.
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Affiliation(s)
- T Ashizawa
- Department of Surgery, Hachioji Medical Center of Tokyo Medical University, Tokyo, Japan
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Makino H, Mukoyama M, Mori K, Suganami T, Kasahara M, Yahata K, Nagae T, Yokoi H, Sawai K, Ogawa Y, Suga S, Yoshimasa Y, Sugawara A, Tanaka I, Nakao K. Transgenic overexpression of brain natriuretic peptide prevents the progression of diabetic nephropathy in mice. Diabetologia 2006; 49:2514-24. [PMID: 16917760 DOI: 10.1007/s00125-006-0352-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2005] [Accepted: 05/15/2006] [Indexed: 01/09/2023]
Abstract
AIMS/HYPOTHESIS Brain natriuretic peptide (BNP) is a potent vasorelaxing and natriuretic peptide that is secreted from the heart and has cardioprotective properties. We have previously generated hypotensive transgenic mice (BNP-Tg mice) that overproduce BNP in the liver, which is released into the circulation. Using this animal model, we successfully demonstrated the amelioration of renal injury after renal ablation and in proliferative glomerulonephritis. Glomerular hyperfiltration is an early haemodynamic derangement, representing one of the key mechanisms of the pathogenesis of diabetic nephropathy. Based on the suggested involvement of increased endogenous natriuretic peptides, the aim of this study was to investigate their role in the development and progression of diabetic nephropathy. MATERIALS AND METHODS We evaluated the progression of renal injury and fibrogenesis in BNP-Tg mice with diabetes induced by streptozotocin. We also investigated the effect of BNP on high glucose-induced signalling abnormalities in mesangial cells. RESULTS After induction of diabetes, control mice exhibited progressively increased urinary albumin excretion with impaired renal function, whereas these changes were significantly ameliorated in BNP-Tg mice. Notably, diabetic BNP-Tg mice revealed minimal mesangial fibrogenesis with virtually no glomerular hypertrophy. Glomerular upregulation of extracellular signal-regulated kinase, TGF-beta and extracellular matrix proteins was also significantly inhibited in diabetic BNP-Tg mice. In cultured mesangial cells, activation of the above cascade under high glucose was abrogated by the addition of BNP. CONCLUSIONS/INTERPRETATION Chronic excess of BNP prevents glomerular injury in the setting of diabetes, suggesting that renoprotective effects of natriuretic peptides may be therapeutically applicable in preventing the progression of diabetic nephropathy.
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Affiliation(s)
- H Makino
- Department of Medicine and Clinical Science, Kyoto University Graduate School of Medicine, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
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Kobayashi H, Kasahara M, Hino M, Yoshimura H, Takahara S, Ikeda K, Son C, Iwakura T, Yoshimoto A, Ishihara T, Ogawa Y. A novel heterozygous deletion frameshift mutation of GATA3 in a Japanese kindred with the hypoparathyroidism, deafness and renal dysplasia syndrome. J Endocrinol Invest 2006; 29:851-3. [PMID: 17114920 DOI: 10.1007/bf03347383] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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39
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Uchida Y, Kasahara M, Egawa H, Takada Y, Ogawa K, Ogura Y, Uryuhara K, Morioka D, Sakamoto S, Inomata Y, Kamiyama Y, Tanaka K. Long-term outcome of adult-to-adult living donor liver transplantation for post-Kasai biliary atresia. Am J Transplant 2006; 6:2443-8. [PMID: 16889600 DOI: 10.1111/j.1600-6143.2006.01487.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Our objective was to analyze problems in the perioperative management and long-term outcome of living donor liver transplantation (LDLT) for biliary atresia (BA). Many reports have described the effectiveness of liver transplantation (LT) for BA, particularly in pediatric cases, but little information is available regarding LT in adults (> or =16 years old). Between June 1990 and December 2004, 464 patients with BA underwent LDLT at Kyoto University Hospital, of whom 47 (10.1%) were older than 16 years. In this study, we compared the outcomes between adult (> or =16 years old) and pediatric (<16 years old) patients. The incidence of post-transplant intestinal perforation, intra-abdominal bleeding necessitating repeat laparotomy and biliary leakage was significantly higher (p < 0.0001, <0.001 and <0.001, respectively) in adults. Overall cumulative 1-, 5- and 10-year survival rates in pediatric patients were significantly higher (p < 0.005) than in adults. Two independent prognostic determinants of survival were identified: a MELD score over 20 and post-transplant complications requiring repeat laparotomy. Outcome of LDLT in adult BA patients was poorer than in pediatric patients. It seems likely that LT will be the radical treatment of choice for BA and that LDLT should be considered proactively at the earliest possible stage.
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Affiliation(s)
- Y Uchida
- Department of Transplantation and Immunology, Kyoto University Faculty of Medicine, Kyoto, Japan.
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Akiba S, Matsuda A, Isa H, Kasahara M, Sato S, Watanabe T, Hara W, Yoshimoto M. Formation of a nanogroove-striped NiO surface using atomic steps. Nanotechnology 2006; 17:4053-4056. [PMID: 21727537 DOI: 10.1088/0957-4484/17/16/010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A nanogroove-striped pattern was formed on a NiO film surface. The periodic nanopattern was successfully obtained over the entire surface via high-temperature annealing of the epitaxial NiO thin film, which was grown on an atomically stepped sapphire substrate at low temperature. The depth, width and interval of straight nanogrooves were about 3 nm, 35 nm and about 100 nm, respectively. The periodicity of the stripe agrees well with that of the atomic steps of the substrate.
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Affiliation(s)
- S Akiba
- Materials and Structures Laboratory, Tokyo Institute of Technology, 4259-R3-6 Nagatsuta-cho, Midori-ku, Yokohama 226-8503, Japan
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Kobayashi H, Fujisawa I, Ikeda K, Son C, Iwakura T, Yoshimoto A, Kasahara M, Ishihara T, Ogawa Y. A novel heterozygous missense mutation in the vasopressin moiety is identified in a Japanese person with neurohypophyseal diabetes insipidus. J Endocrinol Invest 2006; 29:252-6. [PMID: 16682840 DOI: 10.1007/bf03345549] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The autosomal dominant familial neurohypophyseal diabetes insipidus (adFNDI) is caused by diverse mutations in one allele of the gene that encodes the arginine vasopressin (AVP) precursor protein, AVP-neurophysin II (AVP-NP II). Most of the mutations identified so far are located in either the signal peptide or NP II moiety. Two recently published mutations in the AVP gene identified in kindreds with adFNDI predict a substitution of histidine for tyrosine at position 2 and a deletion of phenylalanine at position 3 in AVP. They are unique among adFNDI mutations in that they are the only adFNDI mutations that affect amino acid residues in the AVP moiety of the pro-hormone. Here, we report a novel heterozygous missense mutation in the AVP moiety of the AVP-NP II gene in a Japanese person with neurohypophyseal diabetes insipidus (DI). This mutation occurs at position 2 in AVP and predicts a substitution of serine for tyrosine (Y21S). It is expected to interfere with normal binding of AVP with NP II, and thus result in misfolding of the precursor proteins. The data of this study support the notion that mutations affecting the AVP moiety can result in the initiation of the pathological processes.
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Affiliation(s)
- H Kobayashi
- Department of Endocrinology, Kobe City General Hospital, 4-6, Minatojimanakamachi, Hyogo, 650-0046 Japan.
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Ueda M, Egawa H, Ogawa K, Uryuhara K, Fujimoto Y, Kasahara M, Ogura Y, Kozaki K, Takada Y, Tanaka K. Portal vein complications in the long-term course after pediatric living donor liver transplantation. Transplant Proc 2005; 37:1138-40. [PMID: 15848648 DOI: 10.1016/j.transproceed.2005.01.044] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The frequency and the outcome of patients with portal vein (PV) complications in the long-term course after pediatric living donor liver transplantation (LDLT) have rarely been reported. Between June 1990 and September 2003, 527 pediatric patients underwent primary LDLT with left lobe grafts, among which 479 patients with functioning grafts at 3 months after LDLT were included in this analysis. The ages ranged from 29 days to 17 years, 3 months (median: 1 year, 9 months) and body weight from 3.1 kg to 62.4 kg (median: 9.6 kg). Biliary cirrhosis was the most common cause for LDLT (81%). The PV was anastomosed with or without a vein graft. Thirty-nine patients (8%) showed a PV complication (stenosis: 16; obstruction: 17; thrombus: 2; twist: 3). Their ages ranged from 4 months to 17 years, 3 months (median: 1 year) and their body weight from 3.8 kg to 44.8 kg (median: 8.5 kg) at operation. PV complications were detected between 4 and 116 months (median: 14 months) after the transplant. Splenomegaly and decreased platelet counts were observed in more than 90% of the patients with a PV complication. In 27 patients (71%), interventional venoplasty was successful. Eleven patients had obstruction of the PV (2.3%) including three who showed cirrhosis; one with severe pulmonary hypertension; one death after retransplantation; and one alive after retransplantation. Moderate fibrosis was found in two patients at 3 and 2 years after the procedure, one of whom had the complication of a moderate intrapulmonary shunt. Early detection of PV stenosis with these two markers can lead to successful angioplasty and avoid graft loss.
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Affiliation(s)
- M Ueda
- Department of Transplantation Immunology, Kyoto University Faculty of Medicine, Kyoto University, Kyoto, Japan.
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43
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Yoshizawa A, Sakamoto S, Ogawa K, Kasahara M, Uryuhara K, Oike F, Ueda M, Takada Y, Egawa H, Tanaka K. New protocol of immunosuppression for liver transplantation across ABO barrier: the use of Rituximab, hepatic arterial infusion, and preservation of spleen. Transplant Proc 2005; 37:1718-9. [PMID: 15919443 DOI: 10.1016/j.transproceed.2005.03.148] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION An ABO-incompatible (ABO-I) living donor liver transplantation (LDLT) is a challenge. Until 2000 systemic multidrug immunosuppression and splenectomy was the gold standard with poor results. Application of local administration with prostagrandin E1 (PGE1) and steroids via a portal vein (PV) catheter dramatically improved the survival from 20% to 60% but PV thrombus became a problem (35%). To solve it, an hepatic arterial (HA) catheter was used instead of a PV catheter and splenectomy was omitted. Although the PV thrombus problem was resolved, the ABO antibody titers significantly increased, and two cases of uncontrollable humoral rejection (HR) were experienced. In this study, Rituximab was introduced instead of splenectomy to decrease the antibody. We report the efficacy of prophylaxis with Rituximab for ABO-I LDLT. METHODS Eight patients received. Rituximab at 2 to 14 days before LDLT. During the operation, the spleen was preserved. Methylpredonisolone and PGE1 were administered via an HA catheter for 2 to 3 weeks after LDLT in addition to an immunosuppressive regimen consisting of tacrolimus and steroids. Antibody titers were measured serially. RESULT There was no clinical HR. Two patients died of complications unrelated to HR. The antibody titer decreased compared to patients without splenectomy/rituximab. B cells (CD19) were depleted from peripheral blood for up to 3 months. Cytomegalovirus infections were decreased compared to patients with splenectomy (P = .085). CONCLUSION Rituximab prophylaxis and HA infusion therapy prevented clinical HR, which may provide a breakthrough to overcome the ABO blood-type barrier in liver transplantation.
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Affiliation(s)
- A Yoshizawa
- Kyoto University Graduate School of Medicine, Department of Transplantation and Immunology, Shougoin, Kyoto, Japan.
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Ohsawa Y, Takahashi J, Inoue N, Takahata C, Yoshida K, Miyaishi A, Kasahara M, Kawashima E, Tabuchi Y, Tsubota N. P-300 Genetic polymorphisms of N-acetyltransferase 2 (NAT2) andL-myc can evaluate lung cancer susceptibility by smoking. Lung Cancer 2005. [DOI: 10.1016/s0169-5002(05)80794-9] [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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Busso D, Cohen DJ, Hayashi M, Kasahara M, Cuasnicú PS. Human testicular protein TPX1/CRISP-2: localization in spermatozoa, fate after capacitation and relevance for gamete interaction. ACTA ACUST UNITED AC 2005; 11:299-305. [PMID: 15734896 DOI: 10.1093/molehr/gah156] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Testicular protein Tpx-1, also known as CRISP-2, is a cysteine-rich secretory protein specifically expressed in the male reproductive tract. Since the information available on the human protein is limited to the identification and expression of its gene, in this work we have studied the presence and localization of human Tpx-1 (TPX1) in sperm, its fate after capacitation and acrosome reaction (AR), and its possible involvement in gamete interaction. Indirect immunofluorescence studies revealed the absence of significant staining in live or fixed non-permeabilized sperm, in contrast to a clear labelling in the acrosomal region of permeabilized sperm. These results, together with complementary evidence from protein extraction procedures strongly support that TPX1 would be mainly an intra-acrosomal protein in fresh sperm. After in vitro capacitation and ionophore-induced AR, TPX1 remained associated with the equatorial segment of the acrosome. The lack of differences in the electrophoretic mobility of TPX1 before and after capacitation and AR indicates that the protein would not undergo proteolytical modifications during these processes. The possible involvement of TPX1 in gamete interaction was evaluated by the hamster oocyte penetration test. The presence of anti-TPX1 during gamete co-incubation produced a significant and dose-dependent inhibition in the percentage of penetrated zona-free hamster oocytes without affecting sperm motility, the AR or sperm binding to the oolema. Together, these results indicate that human TPX1 would be a component of the sperm acrosome that remains associated with sperm after capacitation and AR, and is relevant for sperm-oocyte interaction.
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Affiliation(s)
- D Busso
- Instituto de Biología y Medicina Experimental (IBYME), Buenos Aires (1428), Argentina
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Sakaji I, Kasahara M, Ishida Y, Yoshikawa M, Nitta T, Matsushima Y, Iwatani Y, Yoshimoto A, Suzuki T. A case of plasma component exchange using membrane plasma separator EVACUREtm. Hemodial Int 2005. [DOI: 10.1111/j.1492-7535.2005.1121q.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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47
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Ishida Y, Kasahara M, Sakaji I, Yoshikawa M, Nitta T, Matsushima Y, Iwatani Y, Yoshimoto A, Suzuki T. Consideration of free coagulant hemodialysis within our facility. Hemodial Int 2005. [DOI: 10.1111/j.1492-7535.2005.1121p.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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48
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Ali H, Egawa H, Uryuhara K, Ogawa K, Kasahara M, Ueda M, Marusawa H, Nabeshima M, Tanaka K. Prevention of hepatitis B virus recurrence after living donor liver transplantation. Transplant Proc 2004; 36:2764-7. [PMID: 15621143 DOI: 10.1016/j.transproceed.2004.10.035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The emergence of lamivudine-resistant hepatitis B mutations is a major complication during pretransplantation treatment. The proper time to begin Lamivudine before transplantation is not yet known. Twenty-six patients received preoperative lamivudine treatment followed by combined lamivudine and hepatitis B immunoglobulin after transplantation up to December 2002. The length of preoperative lamivudine treatment ranged from 13 to 200 days (mean, 52 +/- 37 days). Hepatitis B virus-DNA was positive in 22 of 26 (84.6%) patients before preoperative lamivudine prophylaxis and persistently positive among only 4 of 22 patients (18%) who at transplantation did not show a viral mutation. In all patients, hepatitis B virus-DNA became negative immediately after transplantation. At a median follow-up of 34 months, neither a hepatitis B recurrence nor a mutation had occurred in any patient. The ability to schedule the proper time for preoperative lamivudine prophylaxis is an advantage of living donor liver transplantation.
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Affiliation(s)
- H Ali
- Graduate School of Medicine, Department of Transplantation Immunology, Kyoto University, Kyoto 606-8507, Japan.
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Yoshioka H, Ishimaru Y, Sugiyama N, Kasahara M, Morohashi K. Mesonephric Wnt signaling associate with a formation of an adreno-gonadal primordium in chick embryos. Endocr Res 2004; 30:523. [PMID: 15666784 DOI: 10.1081/erc-200043613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- H Yoshioka
- Hyogo University of Teacher Education, Hyogo, Japan
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50
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Yoshimoto A, Matsushima Y, Sakaji I, Yoshikawa M, Nitta T, Okuno M, Ishida Y, Kasahara M, Suzuki T. Significance of Measurement for Colloid Osmotic Pressure during Hemodialysis. Hemodial Int 2004. [DOI: 10.1111/j.1492-7535.2004.0085aa.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: 11/30/2022]
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