1
|
Komatsu M, Naito K, Chino S, Tanaka H, Ichimura H, Yamamoto T, Nakahara K, Fuke M, Wada Y, Seto T. Central extracorporeal membrane oxygenation with left-ventricular vent for fulminant myocarditis: a retrospective study. J Artif Organs 2023; 26:297-302. [PMID: 36348184 DOI: 10.1007/s10047-022-01371-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/02/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE Fulminant myocarditis presents as acute severe heart failure and requires mechanical cardiocirculatory support. Left-ventricular (LV) decompression is necessary for the successful recovery of these patients. This retrospective study aimed to evaluate the functional outcomes of providing central extracorporeal membrane oxygenation (ECMO) with LV decompression for the treatment of refractory fulminant myocarditis. METHODS Between January 2015 and February 2021, seven consecutive fulminant myocarditis patients (mean age: 41.1 ± 26.1 years) received central ECMO support with transapical LV decompression, with an 18 French cannula integrated into the ECMO circuit in a Y-fashion. The baseline characteristics and postoperative outcomes of the patients were collected. RESULTS On admission, all patients received prior peripheral ECMO, and 85.7% (6/7) of patients received prior intra-aortic balloon pumping. However, all patients had refractory cardiogenic shock that failed prior to decompression. Six patients recovered successfully after a mean ECMO support of 20.0 ± 11.5 days and five patients had no recurrence of cardiac decompensation. The mean ICU and mean hospital stays were 36.7 ± 23.5 days and 60.6 ± 24.9 days, respectively. Hospital mortality was 28.6% (2/7). Two patients died due to sepsis and stroke during hospitalization. CONCLUSIONS Central ECMO with an LV vent was effective for fulminant myocarditis refractory to percutaneous cardiopulmonary support therapy and other therapies.
Collapse
Affiliation(s)
- Masaki Komatsu
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan
| | - Kazuki Naito
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan
| | - Shuji Chino
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan
| | - Haruki Tanaka
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan
| | - Hajime Ichimura
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan
| | - Takateru Yamamoto
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan
| | - Ko Nakahara
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan
| | - Megumi Fuke
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan
| | - Yuko Wada
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan
| | - Tatsuichiro Seto
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano, 390-8621, Japan.
| |
Collapse
|
2
|
Ichimura H, Chino S, Shiba Y. Cardiac Regeneration Using Pluripotent Stem Cells and Controlling Immune Responses. Heart Lung Circ 2023:S1443-9506(23)00108-7. [PMID: 37029069 DOI: 10.1016/j.hlc.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 11/02/2022] [Accepted: 12/05/2022] [Indexed: 04/08/2023]
Abstract
Pluripotent stem cell (PSC)-derived cardiomyocytes are a promising source of cells in myocardial regeneration therapy for end-stage heart failure. Because most previous reports have focussed on xenotransplantation models using immunocompromised animals, studies on immune rejection in allogeneic transplantation models are needed for preclinical and clinical applications. Human leukocyte antigen (HLA) plays an important role in allogeneic transplantation, and cell bank projects are currently underway worldwide to stock induced pluripotent stem cells (iPSCs) generated from healthy individuals with homozygous HLA haplotypes. However, it is difficult to stock iPSCs that match the entire population in these cell banks; thus, several groups have produced hypoimmunogenic PSCs by knocking out HLA. These HLA-knockout PSCs were able to avoid rejection by T cells but still suffered rejection by natural killer (NK) cells caused by 'missing self-recognition'. Recent studies have attempted to generate hypoimmunogenic PSCs with gene editing to inhibit NK cell activation. Regenerative medicine using autologous iPSCs can be an ideal transplantation therapy, but, currently, there are major hurdles to its practical application. Hopefully, further research will resolve these issues. This review provides an overview of the current understanding and progress in this field.
Collapse
Affiliation(s)
- Hajime Ichimura
- Department of Regenerative Science and Medicine, Shinshu University School of Medicine, Matsumoto, Japan; Department of Surgery, Division of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shuji Chino
- Department of Surgery, Division of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yuji Shiba
- Department of Regenerative Science and Medicine, Shinshu University School of Medicine, Matsumoto, Japan; Institute for Biomedical Sciences, Shinshu University, Matsumoto, Japan.
| |
Collapse
|
3
|
Ouchi T, Kato N, Kato H, Higashigawa T, Ito H, Nakajima K, Chino S, Tokui T, Oue K, Mizumoto T, Sakuma H. Abstract No. 503 Machine Learning Model to Predict Mid-Term All-Cause Mortality after Elective Thoracic Endovascular Aortic Repair for Thoracic Aortic Aneurysm. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
|
4
|
Kobayashi H, Tohyama S, Kanazawa H, Ichimura H, Chino S, Tanaka Y, Suzuki Y, Zhao J, Shiba N, Kadota S, Narita K, Naito T, Seto T, Kuwahara K, Shiba Y, Fukuda K. Intracoronary transplantation of pluripotent stem cell-derived cardiomyocytes: Inefficient procedure for cardiac regeneration. J Mol Cell Cardiol 2023; 174:77-87. [PMID: 36403760 DOI: 10.1016/j.yjmcc.2022.11.004] [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: 04/05/2022] [Revised: 11/08/2022] [Accepted: 11/14/2022] [Indexed: 11/19/2022]
Abstract
Advances in stem cell biology have facilitated cardiac regeneration, and many animal studies and several initial clinical trials have been conducted using human pluripotent stem cell-derived cardiomyocytes (PSC-CMs). Most preclinical and clinical studies have typically transplanted PSC-CMs via the following two distinct approaches: direct intramyocardial injection or epicardial delivery of engineered heart tissue. Both approaches present common disadvantages, including a mandatory thoracotomy and poor engraftment. Furthermore, a standard transplantation approach has yet to be established. In this study, we tested the feasibility of performing intracoronary administration of PSC-CMs based on a commonly used method of transplanting somatic stem cells. Six male cynomolgus monkeys underwent intracoronary administration of dispersed human PSC-CMs or PSC-CM aggregates, which are called cardiac spheroids, with multiple cell dosages. The recipient animals were sacrificed at 4 weeks post-transplantation for histological analysis. Intracoronary administration of dispersed human PSC-CMs in the cynomolgus monkeys did not lead to coronary embolism or graft survival. Although the transplanted cardiac spheroids became partially engrafted, they also induced scar formation due to cardiac ischemic injury. Cardiac engraftment and scar formation were reasonably consistent with the spheroid size or cell dosage. These findings indicate that intracoronary transplantation of PSC-CMs is an inefficient therapeutic approach.
Collapse
Affiliation(s)
- Hideki Kobayashi
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shugo Tohyama
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
| | - Hideaki Kanazawa
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Hajime Ichimura
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan; Department of Regenerative Science and Medicine, Shinshu University, Matsumoto, Japan
| | - Shuji Chino
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yuki Tanaka
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan; Department of Regenerative Science and Medicine, Shinshu University, Matsumoto, Japan
| | - Yota Suzuki
- Department of Neurosurgery, Shinshu University School of Medicine, Matsumoto, Japan; Department of Regenerative Science and Medicine, Shinshu University, Matsumoto, Japan
| | - Jian Zhao
- Department of Regenerative Science and Medicine, Shinshu University, Matsumoto, Japan
| | - Naoko Shiba
- Department of Regenerative Science and Medicine, Shinshu University, Matsumoto, Japan
| | - Shin Kadota
- Institute for Biomedical Sciences, Shinshu University, Matsumoto, Japan; Department of Regenerative Science and Medicine, Shinshu University, Matsumoto, Japan
| | - Kazumasa Narita
- Department of Pharmacy, Shinshu University Hospital, Matsumoto, Japan; Department of Clinical Pharmacology and Therapeutics, Shinshu University Graduate School of Medicine, Matsumoto, Japan
| | - Takafumi Naito
- Department of Pharmacy, Shinshu University Hospital, Matsumoto, Japan; Department of Clinical Pharmacology and Therapeutics, Shinshu University Graduate School of Medicine, Matsumoto, Japan
| | - Tatsuichiro Seto
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Koichiro Kuwahara
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan; Institute for Biomedical Sciences, Shinshu University, Matsumoto, Japan
| | - Yuji Shiba
- Institute for Biomedical Sciences, Shinshu University, Matsumoto, Japan; Department of Regenerative Science and Medicine, Shinshu University, Matsumoto, Japan.
| | - Keiichi Fukuda
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| |
Collapse
|
5
|
Komatsu M, Naito K, Chino S, Tanaka H, Ichimura H, Yamamoto T, Nakahara K, Fuke M, Wada Y, Seto T. Intimal Sarcoma after Endovascular Abdominal Aortic Aneurysm Repair. Ann Vasc Dis 2022; 15:344-347. [PMID: 36644265 PMCID: PMC9816019 DOI: 10.3400/avd.cr.22-00057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 09/05/2022] [Indexed: 11/06/2022] Open
Abstract
A 72-year-old man, who was treated 10 years earlier with endovascular aortic aneurysm repair, presented with a fever. Considering the concern of stent graft infection, the patient was treated with antibiotics, but his condition did not improve. He underwent stent graft resection and reconstruction with a Dacron graft. Pathological analysis of the aortic wall and computed tomography revealed recurrent intimal sarcoma, and the patient underwent resurgery. During follow-up, he underwent two additional resections for local recurrence, but he died 17 months later. Our results suggest that intimal sarcoma should be considered during the follow-up after endovascular aortic aneurysm repair.
Collapse
Affiliation(s)
- Masaki Komatsu
- Department of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan,Corresponding author: Masaki Komatsu, MD. Department of Cardiovascular Surgery, Shinshu University School of Medicine, Asahi 3-1-1, Matsumoto, Nagano 390-8621, Japan Tel: +81-263-37-2657, Fax: +81-263-37-2721, E-mail:
| | - Kazuki Naito
- Department of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Shuji Chino
- Department of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Haruki Tanaka
- Department of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Hajime Ichimura
- Department of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Takateru Yamamoto
- Department of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Ko Nakahara
- Department of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Megumi Fuke
- Department of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Yuko Wada
- Department of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| | - Tatsuichiro Seto
- Department of Cardiovascular Surgery, Shinshu University School of Medicine, Matsumoto, Nagano, Japan
| |
Collapse
|
6
|
Nakahara K, Fujii M, Chino S, Komatsu M, Ichimura H, Yamamoto T, Ohashi N, Fuke M, Wada Y, Seto T. [Successful Removal of Intrapericardial Needle using Needle Guidance System]. Kyobu Geka 2022; 75:593-597. [PMID: 35892297] [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: 06/15/2023]
Abstract
A 41-year-old man stuck himself with needle through his pericardium during suicide attempt. Chest radiography revealed several needles in the bilateral lung fields as well. Computed tomography (CT) and echocardiography showed massive pericardial effusion and a needle penetrating the pericardium. The patient was initially treated conservatively, including pericardial drainage, and, seven days later, we removed the needle using syngo Needle Guidance in hybrid operating room. The length of skin incision was only 2 cm, and the postoperative course was uneventful. No previous studies, to the best of our knowledge, have shown the use of syngo Needle Guidance to remove a needle in the pericardial cavity. This surgical procedure is minimally invasive for the patient.
Collapse
Affiliation(s)
- Ko Nakahara
- Department of Cardiovascular Surgery, Shinshu University, Matsumoto, Japan
| | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
Higashigawa T, Ichikawa Y, Chino S, Nakajima K, Ouchi T, Kato H, Hirano K, Tokui T, Kato N, Sakuma H. Usefulness of 18F-FDG PET/computed tomography in differentiating between subacute and chronic aortic dissection: initial investigation. Nucl Med Commun 2022; 43:794-799. [PMID: 35551162 DOI: 10.1097/mnm.0000000000001575] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES In the selection of thoracic endovascular repair for aortic dissection (AD), it is important to distinguish between the subacute and chronic phases, but there is no reliable way to distinguish between them in patients with unknown onset of AD. The purpose of this study was to assess the diagnostic performance of 2-[18F] fluoro-2-deoxy-d-glucose (18F-FDG)-PET/computed tomography (PET/CT) for discriminating subacute AD from chronic AD. METHODS Thirteen patients with AD who were medically treated and followed up for 6 months were studied. 18F-FDG PET/CT images were obtained for each patient in the subacute phase (the first scan) and at 6 months (the second scan) after the onset. Target-to-background ratio (TBR) was measured as the maximum standardized uptake value (SUV) in the dissected aortic wall divided by blood pool SUV. RESULTS TBR was significantly higher in the first scan (mean ± SD, 1.97 ± 0.32) than in the second scan (1.69 ± 0.29, P = 0.007). The area under the receiver operating characteristic curve of TBR for discriminating subacute AD from chronic AD was 0.76. With a threshold of 1.74, the TBR showed the sensitivity, specificity, and positive and negative predictive value of 85%, 69%, 73%, and 82%, respectively, for the discrimination of subacute AD from chronic AD. CONCLUSION Metabolic assessment of dissected aortic wall by 18F-FDG PET/CT is useful in differentiating between subacute and chronic AD and can provide important information in determining the appropriate indication for treatment for patients with AD of unknown onset.
Collapse
Affiliation(s)
| | | | | | | | - Takafumi Ouchi
- Department of Radiology, Mie University Hospital, Edobashi, Tsu
| | - Hiroaki Kato
- Department of Radiology, Mie University Hospital, Edobashi, Tsu
| | - Koji Hirano
- Department of Cardiovascular Surgery, Ise Red Cross Hospital, Funae, Ise, Mie, Japan
| | - Toshiya Tokui
- Department of Cardiovascular Surgery, Ise Red Cross Hospital, Funae, Ise, Mie, Japan
| | - Noriyuki Kato
- Department of Radiology, Mie University Hospital, Edobashi, Tsu
| | - Hajime Sakuma
- Department of Radiology, Mie University Hospital, Edobashi, Tsu
| |
Collapse
|
8
|
Homma N, Hosono R, Chino S, Takahashi M, Sato K. Effects of Rice Grain Hardness and Milling Conditions on Rice Flour Properties. J JPN SOC FOOD SCI 2022. [DOI: 10.3136/nskkk.69.101] [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: 11/03/2022]
Affiliation(s)
- Noriyuki Homma
- Food Research Center, Niigata Agricultural Research Institute
| | - Ryouta Hosono
- Food Research Center, Niigata Agricultural Research Institute
| | - Shuji Chino
- Food Research Center, Niigata Agricultural Research Institute
| | | | - Kazuhito Sato
- Food Research Center, Niigata Agricultural Research Institute
| |
Collapse
|
9
|
Ouchi T, Kato N, Kato H, Higashigawa T, Ito H, Nakajima K, Chino S, Tokui T, Oue K, Mizumoto T, Sakuma H. Utility of psoas muscle area in selecting older patients feasible for thoracic endovascular aortic repair. Ann Thorac Surg 2022; 114:750-756. [PMID: 35216989 DOI: 10.1016/j.athoracsur.2022.01.050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 01/04/2022] [Accepted: 01/26/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND The impact of psoas muscle mass index (PMI) on overall survival is unknown in older patients undergoing elective thoracic endovascular aortic repair (TEVAR). METHODS We retrospectively reviewed 105 patients 75 years and older who underwent elective TEVAR for descending thoracic aortic aneurysm between January 2010 and December 2019. Psoas muscle area was measured at the L3 level with preoperative computed tomography and adjusted by height2 to derive PMI. The patients were stratified into two groups, Sarcopenia and Non-sarcopenia. Sarcopenia was defined as a PMI < 5.40 cm2/m2 for male and < 3.56 cm2/m2 for female. The overall survival was compared with the age- and sex-matched general population using the one-sample log-rank test. The propensity score adjusted-Cox proportional-hazard model was applied to determine the hazard ratio for all-cause mortality. RESULTS Twenty-three patients died during the follow-up period (median, 3.0 years). Thirty-eight (36%) patients were classified as Sarcopenia. The 5-year overall survival rate was 46% (95% confidence interval, 29-73) in Sarcopenia and 84% (95% confidence interval, 74-94) in Non-sarcopenia. The overall survival was significantly lower in Sarcopenia than in its matched general population (P = .004). Whereas, no statistically significant difference in overall survival was found between Non-sarcopenia and its matched general population (P = .417). Sarcopenia was an independent risk factor for all-cause mortality (adjusted hazard ratio, 2.64; 95% confidence interval, 1.02- 6.82; P = .045). CONCLUSIONS PMI may be a good predictor of mortality in older patients undergoing elective TEVAR for descending thoracic aortic aneurysm.
Collapse
Affiliation(s)
- Takafumi Ouchi
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Noriyuki Kato
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan.
| | - Hiroaki Kato
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | | | - Hisato Ito
- Department of Thoracic and Cardiovascular Surgery, Mie University Hospital, Tsu, Mie, Japan
| | - Ken Nakajima
- Department of Radiology, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Shuji Chino
- Department of Radiology, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Toshiya Tokui
- Department of Thoracic Surgery, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Kensuke Oue
- Department of Cardiovascular Surgery, Kochi Health Sciences Center, Kochi, Kochi, Japan
| | - Toru Mizumoto
- Department of Cardiovascular Surgery, Anjo Kosei Hospital, Anjo, Aichi, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| |
Collapse
|
10
|
Maze Y, Tokui T, Murakami M, Kawaguchi T, Inoue R, Nakamura B, Hirano K, Chino S, Nakajima K, Kato N. Treatment Strategies for Improving the Surgical Outcomes of Ruptured Abdominal Aortic Aneurysm: Single-Center Experience in Japan. Ann Vasc Dis 2022; 15:8-13. [PMID: 35432648 PMCID: PMC8958394 DOI: 10.3400/avd.oa.21-00086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/20/2021] [Indexed: 12/16/2022] Open
Abstract
Objective: We aimed to examine the surgical outcomes of ruptured abdominal aortic aneurysm cases at our hospital and considered strategies for improvement. Material and Methods: We examined the preoperative characteristics of hospital mortality, postoperative complications, and long-term outcomes of 91 surgical cases of ruptured abdominal aortic aneurysm performed between January 2009 and December 2020 at our hospital. Results: Of the 91 cases, 24 died at the hospital (mortality, 26.3%). Mortality was mostly due to hemorrhage/disseminated intravascular coagulation and intestinal necrosis. Ten patients required preoperative aortic clamp by thoracotomy or insertion of intra-aortic balloon occlusion, and eight of them died. Ten patients required open abdominal management due to abdominal compartment syndrome, and five of them died. There was no significant difference between the two groups in terms of the long-term results of the open repair and abdominal endovascular aneurysm repair (EVAR). Conclusion: To improve the surgical outcomes of ruptured abdominal aortic aneurysms, it is necessary to start surgery immediately. Therefore, the choice of surgical method (open surgery or EVAR) should be based on the resources and discretion of the hospital. To prevent postoperative intestinal necrosis, risk factors for acute compartment syndrome should be considered, and open abdominal management should be introduced.
Collapse
Affiliation(s)
- Yasumi Maze
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital
| | - Toshiya Tokui
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital
| | - Masahiko Murakami
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital
| | - Teruhisa Kawaguchi
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital
| | - Ryosai Inoue
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital
| | - Bun Nakamura
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital
| | - Koji Hirano
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital
| | - Shuji Chino
- Department of Radiology, Ise Red Cross Hospital
| | | | | |
Collapse
|
11
|
Nakajima K, Kato N, Chino S, Higashigawa T, Ouchi T, Kato H, Ito H, Tokui T, Mizumoto T, Miyake Y, Sakuma H. Therapeutic window for obtaining favorable remodeling after thoracic endovascular aortic repair of type B aortic dissection. J Vasc Surg 2021; 75:861-867. [PMID: 34627960 DOI: 10.1016/j.jvs.2021.09.043] [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] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/22/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The purpose of the present study was to determine the most appropriate timing for thoracic endovascular aortic repair (TEVAR) of type B aortic dissection (TBAD) in terms of remodeling of the aorta. METHODS A total of 41 patients who had undergone TEVAR for the treatment of aortic dissection were included in the present study. The patients were divided into two groups: those who had undergone TEVAR in the acute or subacute phase (group A) and those who had undergone TEVAR in the chronic phase (group B). The indications for TEVAR as the treatment of TBAD were the presence of aortic rupture or malperfusion of the aortic branches, a maximum aortic diameter of ≥40 mm on the initial diagnostic computed tomography scan, and/or expansion of the aorta of ≥5 mm within 3 months for acute and subacute TBAD. The indication was a maximum aortic diameter of ≥50 mm or expansion of the aorta of ≥5 mm within 1 year for chronic TBAD. The diameters of the aorta, true lumen, and false lumen were measured at the level of the most dilated part of the descending aorta (level M) and at the diaphragm (level D) on the computed tomography scan obtained before TEVAR and at the 2-year follow-up examination. RESULTS The median interval between TEVAR and the onset of TBAD was 0.2 month (interquartile range, 0.03-0.7 month) in group A (n = 21) and 32 months (interquartile range, 4.7-35.2 months) in group B (n = 20). Except for the aortic diameter at level D in group B, favorable remodeling was obtained at both levels in both groups. The diameter change ratio of the aorta at level D was significantly greater in group A than in group B (P = .02). Receiver operating characteristic curve analysis of the interval for a significant decrease in the aortic diameter at level D yielded 4.2 months as the optimal threshold for performing TEVAR (area under the curve, 0.859; 95% confidence interval, 0.7-1.0). CONCLUSIONS TEVAR for TBAD will result in favorable outcomes, irrespective of the timing of the procedure. However, it might be more effective to perform TEVAR within 4.2 months of the onset of TBAD, provided that the TEVAR procedure can be performed safely.
Collapse
Affiliation(s)
- Ken Nakajima
- Department of Radiology, Mie University Hospital, Tsu, Japan
| | - Noriyuki Kato
- Department of Radiology, Mie University Hospital, Tsu, Japan.
| | - Shuji Chino
- Department of Radiology, Ise Red Cross Hospital, Tsu, Japan
| | | | - Takafumi Ouchi
- Department of Radiology, Mie University Hospital, Tsu, Japan
| | - Hiroaki Kato
- Department of Radiology, Mie University Hospital, Tsu, Japan
| | - Hisato Ito
- Department of Cardiovascular Surgery, Mie University Hospital, Tsu, Japan
| | - Toshiya Tokui
- Department of Thoracic Surgery, Ise Red Cross Hospital, Tsu, Japan
| | - Toru Mizumoto
- Department of Cardiovascular Surgery, Anjo Kosei Hospital, Anjo, Japan
| | - Yoichiro Miyake
- Department of Cardiovascular Surgery, Kochi Health Science Center, Kochi, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University Hospital, Tsu, Japan
| |
Collapse
|
12
|
Gomibuchi T, Seto T, Naito K, Chino S, Mikoshiba T, Komatsu M, Tanaka H, Ichimura H, Yamamoto T, Nakahara K, Ohashi N, Fuke M, Wada Y, Okada K. Strategies to improve outcomes for acute type A aortic dissection with cerebral malperfusion. Eur J Cardiothorac Surg 2021; 59:666-673. [PMID: 33253365 DOI: 10.1093/ejcts/ezaa376] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 06/11/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES We aimed to identify predictors of postoperative permanent neurological deficits (PNDs) and evaluate the early management of cerebral perfusion in patients undergoing surgical repair of acute type A aortic dissection with cerebral malperfusion. METHODS Between October 2009 and September 2018, a total of 197 patients with acute type A aortic dissection underwent aortic replacement. Of these, 42 (21.3%) patients had an imaging cerebral malperfusion (ICM). ICM was assessed preoperatively, which also revealed whether dissected supra-aortic branch vessels were occluded or narrowed by a thrombosed false lumen. After September 2017, early reperfusion and extra-anatomic revascularization were performed in cases with ICM. RESULTS Hospital mortality rates for cases with ICM were 4.8% (2/42). Before September 2017, PND were observed in 6 patients (54.5%) with preoperative neurological symptoms (n = 11), and 7 patients (33.3%) without neurological symptoms (n = 21) in patients with ICM. Occlusion or severe stenosis of supra-aortic branch vessels (odds ratio, 7.66; P < 0.001), regardless of preoperative clinical neurological symptoms, was a risk factor for PND. After September 2017, 7 of 10 patients with ICM underwent early reperfusion and extra-anatomic revascularization. PND did not occur in any of these 7 patients. CONCLUSIONS Occlusion or severe stenosis of supra-aortic branch vessels is a predictor of PND risk in patients undergoing surgery for acute type A aortic dissection. Early reperfusion and extra-anatomic revascularization may reduce the risk of neurological complications in patients with ICM, with or without neurological symptoms.
Collapse
Affiliation(s)
- Toshihito Gomibuchi
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tatsuichiro Seto
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kazuki Naito
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shuji Chino
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Toru Mikoshiba
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masaki Komatsu
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Haruki Tanaka
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hajime Ichimura
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takateru Yamamoto
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Ko Nakahara
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Noburo Ohashi
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Megumi Fuke
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yuko Wada
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kenji Okada
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
13
|
Ouchi T, Kato N, Kato H, Higashigawa T, Ito H, Nakajima K, Chino S, Tokui T, Mizumoto T, Sakuma H. Relevance of Aortic Dissection Chronicity to the Development of Stent Graft-induced New Entry. Ann Thorac Surg 2020; 110:1983-1989. [PMID: 32479754 DOI: 10.1016/j.athoracsur.2020.04.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/24/2020] [Accepted: 04/03/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The relevance of aortic dissection chronicity to the development of stent graft-induced new entry (SINE) is unknown. METHODS This study enrolled 69 patients who underwent thoracic endovascular aortic repair (TEVAR) for chronic aortic dissection from January 2006 to December 2017 and were followed up for ≥6 months. Their medical records were reviewed retrospectively. Patients were stratified according to TEVAR timing into an early group (≤6 months from the onset of aortic dissection) and a late group (>6 months after the onset). The incidence of SINE as well as the interval between TEVAR and the development of SINE was compared between these groups. RESULTS During the follow-up period, SINE occurred in 12% (3/26) and 35% (15/43) of patients in the early and late groups, respectively (P = .029). The interval between TEVAR and SINE development was significantly longer in the late group than the early group (median, 92 days vs 1144 days, respectively; P = .002). According to the multivariate analysis results, the late group (hazard ratio, 3.667; 95% confidence interval, 1.037-12.968; P = .044) and the distal oversizing ratio (hazard ratio, 1.492; 95% confidence interval, 1.071-2.080; P = .018) were the independent predictors for SINE development. CONCLUSIONS TEVAR should be performed in the early period of the chronic phase to prevent SINE. Close and lifelong follow-up is mandatory for patients who undergo TEVAR >6 months after onset because SINE can develop several years after TEVAR in those patients.
Collapse
Affiliation(s)
- Takafumi Ouchi
- Department of Radiology, Mie University Hospital, Tsu, Japan
| | - Noriyuki Kato
- Department of Radiology, Mie University Hospital, Tsu, Japan.
| | - Hiroaki Kato
- Department of Radiology, Mie University Hospital, Tsu, Japan
| | | | - Hisato Ito
- Department of Thoracic and Cardiovascular Surgery, Mie University Hospital, Tsu, Japan
| | - Ken Nakajima
- Department of Radiology, Ise Red Cross Hospital, Ise, Japan
| | - Shuji Chino
- Department of Radiology, Ise Red Cross Hospital, Ise, Japan
| | - Toshiya Tokui
- Department of Thoracic Surgery, Ise Red Cross Hospital, Ise, Japan
| | - Toru Mizumoto
- Department of Cardiovascular Surgery, Anjo Kosei Hospital, Aichi, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University Hospital, Tsu, Japan
| |
Collapse
|
14
|
Chino S, Mochizuki Y, Toyosaki E, Ota M, Mizuma K, Nohara T, Sawai A, Shinke T. Utility of transcranial color flow imaging for detecting high risk morphology of patent foramen ovale in patients with cerebral infarction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Micro-bubble test by using transcranial color flow imaging (TCCFI) is important as a screening evaluation for diagnosis of paradoxical cerebral embolism which requires the proof of right to left shunt at atrial septum. In addition, high risk features of patent foramen ovale (PFO) that may allow thrombus to easily pass through the PFO itself were previously reported. However, little is known about the association between the degrees on micro-bubble test by TCCFI and the features of high risk PFO.
Purpose
Our aim is to clarify the relationship between the degree of micro-bubble test in TCCFI and the morphology of PFO from transesophageal echocardiography (TEE).
Methods
Seventy-seven patients in whom cardiogenic embolism was strongly suspected by neurologists in Showa University from April to December in 2019 were retrospectively studied. 55 patients underwent both TCCFI and TEE with sufficient Valsalva stress. TCCFI grade of micro-bubble test was classified into 3 groups (A: none, B: small, and C: massive), in which signified “none” is no sign of micro-embolic signals (MES) within 30 seconds, “small” is 1 or more MES, and “massive” is so much MES look like a curtain (Figure). Evaluated high risk characteristics of PFO for cerebral embolism as previously reported were as follows; (1) tunnel height, (2) tunnel length, (3) total excursion distance into right and left atrium, (4) existence of Eustachian valve or Chiari network, (6) angle of PFO from inferior vena cava (7) large shunt (20 or more micro-bubbles).
Results
Of all TCCFI-positive patients (n=32; Group B=19, Group C=13) with cerebral embolism, PFOs were detected in 23 patients in TEE. Therefore, the sensitivity and specificity of TCCFI to PFO were 87% and 63% (AUC=0.75, p<0.001, respectively). Interestingly, all 13 patients (Group C) had manifest PFOs. Moreover, group C include 2 patients with platypnea orthodeoxia syndrome in which hypoxia in the sitting position becomes apparent. Among PFO-positive patients, tunnel height, length, total excursion distance into right and left atrium, and large shunt in TEE were significantly larger in Group C than Group B (p<0.05).
Conclusions
Micro-bubble test by using TCCFI may have screening advantages in predicting paradoxical cerebral embolism, high-risk morphology of PFO, and platypnea orthodeoxia syndrome.
Figure 1
Funding Acknowledgement
Type of funding source: None
Collapse
Affiliation(s)
- S Chino
- Showa University Hospital, Tokyo, Japan
| | | | | | - M Ota
- Showa University Hospital, Tokyo, Japan
| | - K Mizuma
- Showa University Hospital, Tokyo, Japan
| | - T Nohara
- Showa University Hospital, Tokyo, Japan
| | - A Sawai
- Showa University Hospital, Tokyo, Japan
| | - T Shinke
- Showa University Hospital, Tokyo, Japan
| |
Collapse
|
15
|
Hirano K, Tokui T, Nakamura B, Inoue R, Hirano R, Maze Y, Chino S, Ito H, Shomura Y, Takao M. Understanding Vascular Anatomy is Key to Successful Endovascular Treatment of Pancreaticoduodenal Artery Aneurysms. Ann Vasc Dis 2020; 13:330-334. [PMID: 33384741 PMCID: PMC7751088 DOI: 10.3400/avd.cr.20-00011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Pancreaticoduodenal artery aneurysm (PDAA) is a rare disease without treatment guidelines. We present two patients with PDAA. The first patient was a 70-year-old man with a pseudoaneurysm in the anterior superior pancreaticoduodenal artery (ASPDA), for which we achieved exclusion by endovascular coil embolization. The second patient was a 63-year-old woman with a PDAA in the ASPDA with celiac axis obstruction. Endovascular coil embolization of the aneurysm and the ASPDA was successful without visceral organ ischemia. Endovascular treatment is effective for PDAAs, but careful evaluation of collateral circulation is vital in PDAAs with celiac axis obstruction.
Collapse
Affiliation(s)
- Koji Hirano
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital
| | - Toshiya Tokui
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital
| | - Bun Nakamura
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital
| | - Ryosai Inoue
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital
| | - Reina Hirano
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital
| | - Yasumi Maze
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital
| | - Shuji Chino
- Department of Radiology, Ise Red Cross Hospital
| | - Hisato Ito
- Department of Thoracic and Cardiovascular Surgery, Mie University Hospital
| | - Yu Shomura
- Department of Thoracic and Cardiovascular Surgery, Mie University Hospital
| | - Motoshi Takao
- Department of Thoracic and Cardiovascular Surgery, Mie University Hospital
| |
Collapse
|
16
|
Kato H, Kato N, Nakajima K, Higashigawa T, Ouchi T, Chino S, Tokui T, Sakuma H. Parallel Placement of Excluder Legs to Treat Abdominal Aortic Aneurysms with Aortoiliac Occlusive Lesion. Ann Vasc Dis 2020; 13:319-321. [PMID: 33384738 PMCID: PMC7751086 DOI: 10.3400/avd.cr.20-00044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The effectiveness of endovascular aneurysm repair (EVAR) has been proven, but anatomical limitations, including narrow access route, may obstruct procedure of EVAR and cause serious complications. Parallel placement of Excluder legs (W. L. Gore & Associates, Inc., Newark, DE, USA) was established to treat patients with type IIIb endoleak or those with a narrow aorta, who could not be treated using a standard main body. In this report, we applied this technique in two patients with aortoiliac aneurysms with occlusive lesion.
Collapse
Affiliation(s)
- Hiroaki Kato
- Department of Radiology, Mie University Hospital
| | | | | | | | | | - Shuji Chino
- Department of Radiology, Ise Red Cross Hospital
| | - Toshiya Tokui
- Department of Cardiovascular Surgery, Ise Red Cross Hospital
| | | |
Collapse
|
17
|
Kato H, Kato N, Nakajima K, Higashigawa T, Ouchi T, Chino S, Sakuma H. Parallel Placement of Excluder Legs for the Treatment of a Type IIIb Endoleak Using AFX2. Ann Vasc Dis 2020; 13:180-182. [PMID: 32595796 PMCID: PMC7315243 DOI: 10.3400/avd.cr.19-00110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Endoleak is a major complication of endovascular aneurysm repair (EVAR). Type IIIb endoleaks, which are caused by endograft fabric disruption, are relatively rare. Although relining of the previously placed endograft with another main endograft is considered an ideal approach, it is sometimes difficult. The efficacy of parallel placement of Excluder legs has been reported in various settings. Here, we report the successful treatment of a type IIIb endoleak with parallel placement of Excluder legs during EVAR by using an AFX2 device.
Collapse
Affiliation(s)
- Hiroaki Kato
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Noriyuki Kato
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Ken Nakajima
- Department of Radiology, Ise Red Cross Hospital, Ise, Mie, Japan
| | | | - Takafumi Ouchi
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Shuji Chino
- Department of Radiology, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| |
Collapse
|
18
|
Higashigawa T, Ichikawa Y, Chino S, Nakajima K, Ouchi T, Kato H, Hirano K, Tokui T, Kato N, Sakuma H. 18F-FDG uptake as a predictive factor for progressive aortic enlargement in aortic dissection. Ann Nucl Med 2020; 34:636-642. [PMID: 32557014 DOI: 10.1007/s12149-020-01487-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 06/08/2020] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Progressive aortic enlargement (PAE) is a critical adverse event in patients with medically treated aortic dissection (AD). However, no reliable predictor of the PAE has been established. The purpose of this study was to evaluate the value of 18F-FDG PET/CT for the prediction of PAE in patients with medically treated AD. METHODS Sixteen patients with AD who underwent optimal medical therapy were enrolled. 18F-FDG PET/CT examinations were performed in subacute phase (2 weeks-3 months) after the onset of AD. Target-to-background ratio (TBR) was measured as the maximum standardized uptake value (SUV) in the dissected aortic wall divided by blood pool SUV. The relation between TBR and occurrence of PAE (> 10 mm/year) was evaluated. RESULTS PAE was observed in four patients during the median follow-up period of 24 months. The TBR measured in the 4 patients showing PAE was significantly higher than that in the remaining 12 patients without PAE (2.44 ± 0.56 vs 1.87 ± 0.33, P = 0.025). The area under the receiver operating characteristic curve of TBR for predicting PAE was 0.82. With a threshold of 2.34, the TBR showed the sensitivity, specificity, and positive and negative predictive value of 75%, 92%, 75%, and 92%, respectively, for the prediction of PAE. CONCLUSIONS Higher 18F-FDG uptake in the dissected aortic wall as determined by TBR is associated with increased risk of PAE in patients with medically treated AD. TBR shows good specificity and negative predictive value for predicting PAE.
Collapse
Affiliation(s)
- Takatoshi Higashigawa
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan.
| | - Yasutaka Ichikawa
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Shuji Chino
- Department of Radiology, Ise Red Cross Hospital, 471-2 1-Chome Funae, Ise, Mie, 516-8512, Japan
| | - Ken Nakajima
- Department of Radiology, Ise Red Cross Hospital, 471-2 1-Chome Funae, Ise, Mie, 516-8512, Japan
| | - Takafumi Ouchi
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Hiroaki Kato
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Koji Hirano
- Department of Cardiovascular Surgery, Ise Red Cross Hospital, 471-2 1-Chome Funae, Ise, Mie, 516-8512, Japan
| | - Toshiya Tokui
- Department of Cardiovascular Surgery, Ise Red Cross Hospital, 471-2 1-Chome Funae, Ise, Mie, 516-8512, Japan
| | - Noriyuki Kato
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| | - Hajime Sakuma
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan
| |
Collapse
|
19
|
Gomibuchi T, Seto T, Chino S, Mikoshiba T, Komatsu M, Tanaka H, Ichimura H, Yamamoto T, Ohashi N, Fuke M, Wada Y, Okada K. Skeletal muscle quality affects patient outcomes in acute type A aortic dissection. Interact Cardiovasc Thorac Surg 2020; 30:739-745. [PMID: 32163575 DOI: 10.1093/icvts/ivaa008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/17/2019] [Accepted: 01/06/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Although skeletal muscle quantity is linked to surgical outcomes, quality remains unexamined. In this study, we evaluated whether skeletal muscle quality and quantity could predict surgical outcomes in acute type A aortic dissection (ATAAD). METHODS Skeletal muscle quality and quantity were evaluated using computed tomography (CT) values and the psoas muscle mass index, respectively. From May 2004 to December 2017, 324 ATAAD patients underwent aortic replacement after CT scans and psoas muscle mass index measurements. Patients were grouped into intramuscular fat (IMF; n = 55) and non-IMF (n = 269) deposition groups. RESULTS The mean ages of the patients were 72.3 ± 9.7 and 66.8 ± 12.1 years (P = 0.002), and hospital mortality rates were 3.6% (2/55) and 7.4% (20/269; P = 0.393) for IMF and non-IMF deposition groups, respectively. IMF deposition was a risk factor for a deterioration in activities of daily living at discharge by multivariable analysis [odds ratio 0.33, 95% confidence interval (CI) 0.16-0.69; P = 0.003]. The mean follow-up was 43.9 ± 36.8 months. The 5-year survival was significantly worse for the IMF deposition group (IMF 73.8% vs non-IMF 88.2%; P = 0.010). The multivariable Cox proportional hazard analysis showed that IMF deposition significantly predicted poor survival (hazard ratio 3.26, 95% CI 1.47-7.24; P = 0.004), unlike psoas muscle mass index and age. CONCLUSIONS Skeletal muscle quality, defined by IMF deposition, was an independent predictor of overall survival and postoperative activities of daily living dependence risk in patients undergoing surgery for ATAAD. Thus, IMF deposition may be an additional risk factor for estimating late outcomes of ATAAD surgery.
Collapse
Affiliation(s)
- Toshihito Gomibuchi
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Tatsuichiro Seto
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Shuji Chino
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Toru Mikoshiba
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Masaki Komatsu
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Haruki Tanaka
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Hajime Ichimura
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Takateru Yamamoto
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Noburo Ohashi
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Megumi Fuke
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yuko Wada
- Division of Cardiovascular Surgery, Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan
| | - Kenji Okada
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| |
Collapse
|
20
|
Hirano K, Tokui T, Nakamura B, Inoue R, Inagaki M, Hirano R, Chino S, Maze Y, Kato N, Takao M. Impact of the Frozen Elephant Trunk Technique on Total Aortic Arch Replacement. Ann Vasc Surg 2020; 65:206-216. [DOI: 10.1016/j.avsg.2019.10.075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 10/08/2019] [Accepted: 10/14/2019] [Indexed: 12/11/2022]
|
21
|
Higashigawa T, Kato N, Nakajima K, Chino S, Hashimoto T, Ouchi T, Tokui T, Maze Y, Mizumoto T, Teranishi S, Yamamto N, Ito H, Sakuma H. Thoracic endovascular aortic repair for retrograde type A aortic dissection. J Vasc Surg 2019; 69:1685-1693. [DOI: 10.1016/j.jvs.2018.08.193] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 08/31/2018] [Indexed: 11/27/2022]
|
22
|
Hirano K, Tokui T, Nakamura B, Inoue R, Inagaki M, Toyoshima H, Chino S, Watanabe F, Kato N, Maze Y. Hybrid Therapy for Mycotic Aortic Aneurysm with Stent-Graft and Video-Assisted Thoracoscopic Debridement. Ann Vasc Dis 2019; 12:69-73. [PMID: 30931062 PMCID: PMC6434360 DOI: 10.3400/avd.cr.18-00119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Treating mycotic aortic aneurysm with thoracic endovascular aortic repair (TEVAR) remains controversial because of sustained infection post-treatment. In this study, an 83-year-old man, who had a ruptured mycotic thoracic aortic aneurysm, underwent salvage TEVAR. However, because an abscess appeared in the aneurysm on follow-up computed tomography, video-assisted thoracoscopic debridement (VATD) followed by continuous drainage was performed next and was successful in eliminating the infection from the abscess. Although frozen elephant trunk and proximal aortic arch repair were further required owing to another pseudoaneurysm, there was no sign of recurrent infection thereafter. The combination of TEVAR and VATD can be effective in treatment of mycotic aortic diseases in selected patients.
Collapse
Affiliation(s)
- Koji Hirano
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Toshiya Tokui
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Bun Nakamura
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Ryosai Inoue
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Masahiro Inagaki
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Hirokazu Toyoshima
- Department of Infectious Diseases, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Shuji Chino
- Department of Radiology, Ise Red Cross Hospital, Ise, Mie, Japan
| | - Fumiaki Watanabe
- Department of Respiratory Surgery, Matsusaka City Hospital, Matsusaka, Mie, Japan
| | - Noriyuki Kato
- Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Yasumi Maze
- Department of Thoracic and Cardiovascular Surgery, Ise Red Cross Hospital, Ise, Mie, Japan
| |
Collapse
|
23
|
Chino S, Kato N, Nakajima K, Hashimoto T, Higashigawa T, Ouchi T, Kato H, Yamamoto N, Ito H, Maze Y, Tokui T, Sakuma H. Thoracic endovascular aortic repair for the treatment of ruptured acute type B aortic dissection. Jpn J Radiol 2019; 37:321-327. [DOI: 10.1007/s11604-019-00813-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 01/18/2019] [Indexed: 11/27/2022]
|
24
|
Ouchi T, Kato N, Nakajima K, Higashigawa T, Hashimoto T, Chino S, Sakuma H. Splenic Artery Aneurysm Treated With Endovascular Stent Grafting: A Case Report and Review of Literature. Vasc Endovascular Surg 2018; 52:663-668. [PMID: 29940816 DOI: 10.1177/1538574418785252] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION: Although endovascular therapy is becoming an alternative to open surgical repair of splenic artery aneurysms (SAAs), reports on the use of stent grafts for SAA repair are limited. We present our experience of endovascular therapy using a stent graft for the treatment of an SAA that had ruptured into the gastric lumen. We also reviewed 18 cases of stent graft repair for SAAs, including the present case. CASE REPORT: A 43-year-old man was admitted due to hematemesis. Endoscopic examination and contrast-enhanced computed tomography (CT) revealed a dissecting SAA that had ruptured into the stomach. Two 10 × 100 mm Viabahn (W.L. Gore, Flagstaff, Arizona) stent grafts were used to exclude the aneurysm. No complications occurred during the procedure. Although postoperative CT showed complete exclusion of the aneurysm, endoscopic examination showed a discharge of purulent matter from the aneurysm. Therefore, surgical debridement and omental implantation were added to avoid stent graft infection. Follow-up CT obtained 1 year later showed the residual aneurysm almost disappeared without any evidence of infection. LITERATURE REVIEW: A literature search in the PubMed database returned 17 cases with sufficient data. Review of these cases, together with the present case, revealed a 100% technical success rate, 11% splenic infarction rate, 94% graft patency rate, and 0% reintervention rate. CONCLUSION: Endovascular repair of SAAs using stent grafts appears to be safe and effective. In terms of preserving the blood flow and avoiding splenic infarction, it may be superior to coil embolization. Even in a case with aneurysm infection, stent graft repair may be an acceptable method to minimize invasion of concomitant surgical intervention.
Collapse
Affiliation(s)
- Takafumi Ouchi
- 1 Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Noriyuki Kato
- 1 Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Ken Nakajima
- 1 Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | | | | | - Shuji Chino
- 1 Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| | - Hajime Sakuma
- 1 Department of Radiology, Mie University Hospital, Tsu, Mie, Japan
| |
Collapse
|
25
|
Nakajima K, Kato N, Hashimoto T, Chino S, Higashigawa T, Ouchi T, Tokui T, Miyake Y, Sakuma H. Treatment of Infected Aneurysm with Combined Endovascular Aneurysm Repair and Abscess Drainage. J Vasc Interv Radiol 2018; 29:188-193. [DOI: 10.1016/j.jvir.2017.09.014] [Citation(s) in RCA: 5] [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: 05/25/2017] [Revised: 08/30/2017] [Accepted: 09/19/2017] [Indexed: 10/18/2022] Open
|
26
|
Hashimoto T, Kato N, Tokui T, Miyake Y, Nasu M, Nakajima K, Higashigawa T, Chino S. Parallel placement of Excluder legs for treatment of type IIIb endoleaks caused by fabric tear after endovascular aneurysm repair. J Vasc Surg 2017; 66:1285-1289. [PMID: 28705593 DOI: 10.1016/j.jvs.2017.06.072] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 06/15/2017] [Indexed: 11/19/2022]
Abstract
A total of 576 patients underwent endovascular aneurysm repair using main body devices for treatment of abdominal aortic aneurysms or iliac artery aneurysms. During follow-up, type IIIb endoleaks caused by fabric tear occurred in six patients (1.0% [6/576]). The device used was Zenith (Cook Medical, Bloomington, Ind) in five cases and Talent (Medtronic, Santa Rosa, Calif) in one case. All endoleaks were close to the flow divider of the main body devices. The distance between the lower renal artery and the top end of the contralateral leg was 53 ± 14 mm. Bell-bottom-shaped Excluder (W. L. Gore & Associates, Flagstaff, Ariz) legs were placed parallel from the top of the main body device through both legs to treat these endoleaks. In two patients, coil embolization was required to treat gutter endoleaks. Postoperative computed tomography showed the obliteration of type IIIb endoleaks in all patients. Our technique may be an acceptable method for treatment of type IIIb endoleaks, especially when they occur near the flow divider.
Collapse
Affiliation(s)
| | - Noriyuki Kato
- Department of Radiology, Mie University Hospital, Tsu, Japan
| | - Toshiya Tokui
- Department of Cardiovascular Surgery, Ise Red Cross Hospital, Ise, Japan
| | - Yoichiro Miyake
- Department of Cardiovascular Surgery, Kochi Health Sciences Center, Kochi, Japan
| | - Michihiro Nasu
- Department of Cardiovascular Surgery, Toyooka Public Hospital, Toyooka, Japan
| | - Ken Nakajima
- Department of Radiology, Mie University Hospital, Tsu, Japan
| | | | - Shuji Chino
- Department of Radiology, Mie University Hospital, Tsu, Japan
| |
Collapse
|
27
|
Higashigawa T, Kato N, Hashimoto T, Inouchi M, Chino S, Yamamoto N, Yuasa U, Tokui T, Noda Y, Oue K, Okabe M. Upside down use of Gore Excluder or Cook Zenith legs. Cardiovasc Intervent Radiol 2013; 37:1068-72. [PMID: 24305987 DOI: 10.1007/s00270-013-0802-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [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: 04/27/2013] [Accepted: 10/26/2013] [Indexed: 11/27/2022]
Abstract
PURPOSE Endovascular aneurysm repair is becoming increasingly popular. This technical note describes the usefulness of the upside-down technique of Gore Excluder or Cook Zenith legs. METHODS Four patients with iliac or abdominal aortic aneurysms were treated. Three patients with isolated iliac artery aneurysms and one patient with an abdominal aortic aneurysm, in which the neck diameters were unfit for commercially available stent-grafts, were treated using an Excluder or a Zenith leg in an upside-down technique. RESULTS The aneurysms were completely excluded and no endoleak occurred. There were no serious adverse events. CONCLUSIONS The upside-down technique using an Excluder leg or a Zenith leg is both feasible and effective.
Collapse
Affiliation(s)
- Takatoshi Higashigawa
- Department of Radiology, Mie University Hospital, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan,
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Kato N, Inouchi M, Chino S. [Endovascular therapy of abdominal aortic aneurysms: present and future status in Japan]. Nihon Geka Gakkai Zasshi 2011; 112:32-37. [PMID: 21387598] [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: 05/30/2023]
Abstract
Since the Ministry of Health, Labor, and Welfare approved Cook's Zenith AAA in 2006, endovascular repair of abdominal aortic aneurysms (AAAs) has become a widespread, acceptable alternative to traditional surgical intervention in Japan, although it lagged far behind Western countries in adopting this technique. The number of patients who undergo endovascular aortic aneurysm repair (EVAR) is now 3,000 annually and it is expected to exceed 4,000 in the near future, which means that more than half of patients with abdominal aortic or iliac arterial aneurysms will undergo EVAR. A paradigm shift has thus emerged in the field of AAA repair, in which surgical graft replacement was the gold standard for more than 50 years. EVAR is now under the strict control of the Japanese Committee for Stentgraft Management (JACSM), which was established by 10 societies related to endovascular therapy. This appears to be one of the reasons why the outcomes of EVAR in Japan are markedly better compared with those in other countries. EVAR has made it possible to treat high-risk patients because it does not require laparotomy. Therefore, patients who would have been observed without intervention in the past can now benefit from EVAR. In Japan, an extremely aged society, endovascular repair will become a much more common measure for the treatment of patients with AAA.
Collapse
Affiliation(s)
- Noriyuki Kato
- Department of Radiology, Mie University Hospital, Tsu, Japan
| | | | | |
Collapse
|
29
|
Chino S, Kato N, Shimono T, Takeda K. Intimal Tear After Endovascular Repair of Chronic Type B Aortic Dissection. Ann Thorac Surg 2009; 88:2029-31. [DOI: 10.1016/j.athoracsur.2009.04.086] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2008] [Revised: 03/16/2009] [Accepted: 04/21/2009] [Indexed: 11/27/2022]
|
30
|
Ichikawa Y, Kitagawa K, Chino S, Ishida M, Matsuoka K, Tanigawa T, Nakamura T, Hirano T, Takeda K, Sakuma H. Adipose Tissue Detected by Multislice Computed Tomography in Patients After Myocardial Infarction. JACC Cardiovasc Imaging 2009; 2:548-55. [DOI: 10.1016/j.jcmg.2009.01.010] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2008] [Revised: 01/12/2009] [Accepted: 01/15/2009] [Indexed: 12/20/2022]
|
31
|
Sakuma H, Ichikawa Y, Chino S, Hirano T, Makino K, Takeda K. Detection of coronary artery stenosis with whole-heart coronary magnetic resonance angiography. J Am Coll Cardiol 2006; 48:1946-50. [PMID: 17112982 DOI: 10.1016/j.jacc.2006.07.055] [Citation(s) in RCA: 222] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2005] [Revised: 06/21/2006] [Accepted: 07/12/2006] [Indexed: 02/07/2023]
Abstract
OBJECTIVES We sought to determine the diagnostic performance of whole-heart coronary magnetic resonance (MR) angiography for detecting significant coronary artery disease. BACKGROUND The accuracy of whole-heart coronary MR angiography has not been determined in a large number of patients. METHODS Three-dimensional coronary MR angiograms covering the entire heart were obtained during free breathing in 131 patients. Images were acquired during a patient-specific time window in the cardiac cycle with minimal motion of the coronary artery. Significant coronary artery disease was defined on X-ray coronary angiography as a diameter reduction of > or =50% in coronary arteries with a reference diameter of > or =2 mm. RESULTS The acquisition of MR angiography was completed in 113 (86%) of 131 patients, with an imaging time averaged at 12.9 +/- 4.3 min. On a patient-based analysis, the sensitivity, specificity, positive and negative predictive value, and accuracy of MR angiography were 82% (95% confidence interval [CI] 69% to 91%), 90% (95% CI 79% to 96%), 88% (95% CI 74% to 95%), 86% (95% CI 75% to 93%), and 87% (95% CI 79% to 92%), respectively. These values in the individual segments were 78% (95% CI 68% to 85%), 96% (95% CI 95% to 97%), 69% (95% CI 60% to 77%), 98% (95% CI 96% to 98%), and 94% (95% CI 96% to 96%). CONCLUSIONS Whole-heart coronary MR angiography allows for noninvasive detection of significant narrowing in coronary arterial segments with a diameter of > or =2 mm with moderate sensitivity and high specificity.
Collapse
Affiliation(s)
- Hajime Sakuma
- Department of Radiology, Mie University Hospital, Mie, Japan.
| | | | | | | | | | | |
Collapse
|
32
|
Konishi K, Kuriyama K, Chino S, Isohashi K, Murata M, Tsuda K, Mitani T, Maeda M, Kadota T, Arisawa J. [CT evaluation of response to chemotherapy and/or radiotherapy in primary lung cancer: comparison of response evaluation criteria in solid tumors (RECIST) and the WHO criteria, and comparison of both methods with the histological evaluation]. Nihon Igaku Hoshasen Gakkai Zasshi 2004; 64:41-5. [PMID: 14994510] [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: 04/29/2023]
Abstract
PURPOSE The new RECIST criteria for evaluation of tumor response to chemotherapy and/or radiotherapy were proposed in 1999. We compared RECIST with the WHO criteria and also compared both methods with the histological findings, to evaluate RECIST. SUBJECTS AND METHODS The subjects were 32 primary lung cancer patients operated on after chemotherapy and/or radiotherapy. Two radiologists measured the diameter of the tumors and compared the RECIST and WHO criteria using the McNemar test. We also compared both criteria with the histological results. RESULTS Using RECIST, partial response (PR) was assessed in 12 cases, stable disease (SD) in 18, and progressive disease (PD) in 2. With the WHO criteria, PR was seen in 15, no change (NC) in 15, and PD in 2. The two evaluations corresponded in 29 of 32 cases, and the p-value was 0.2500. Ef.1b-2 (good histological effect) was much higher in PR, and to evaluate the size of the tumors was useful, although more than half of SD was Ef.1b-2. CONCLUSION RECIST criteria corresponded almost perfectly with the WHO criteria, suggesting that RECIST is accurate and useful.
Collapse
Affiliation(s)
- Koji Konishi
- Department of Diagnostic Radiology, Osaka Medical Center for Cancer and Cardiovascular Diseases
| | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Chino S, Kuriyama K, Isohashi K, Murata M, Mitani H, Tsuda K, Maeda M, Kadota T, Arisawa J. [Percutaneous localization of pulmonary nodules with CT guidance for lung resection: use of dyes]. Nihon Igaku Hoshasen Gakkai Zasshi 2003; 63:308-10. [PMID: 12934548] [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: 03/04/2023]
Abstract
OBJECTIVE The purpose of this study was to assess the benefits of computed tomography(CT)-guided marking using dyes in patients undergoing lung resection for peripheral nodules. METHODS Between January 1997 and August 2002, the location of small pulmonary nodules was identified with the aid of CT-guided marking in 52 patients scheduled for surgery. Dye-injection was performed in 52 patients (indigo carmine, n = 15; indocyanine green, n = 37). The average nodule size was 9.2 mm (range, 3 to 18 mm). RESULTS The procedure using dyes proved to be easy and safe: the dyes were easily injected near the nodules, and no serious complications ensued. Intraoperatively, indocyanine was superior to indigo carmine with respect to visualization of the dyed pleural surface. CONCLUSION The preoperative CT-guided injection of indocyanine green proved to be the most useful and safest technique for identifying peripheral pulmonary nodules in patients scheduled for thoracoscopic surgery or minimal thoracotomy.
Collapse
Affiliation(s)
- Shuji Chino
- Department of Diagnostic Radiology, Osaka Medical Center for Cancer and Cardiovascular Disease
| | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Suzuki K, Arakawa Y, Chino S, Yagi K. [Hepatic osteodystrophy]. Nihon Rinsho 1998; 56:1604-8. [PMID: 9648489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Bone thinning causing both fractures and severe pain not associated with fractures has been recognized in patients with chronic liver diseases. The patients most commonly affected are those with primary or secondary biliary cirrhosis, but those with alcoholic liver disease and cirrhosis after active chronic hepatitis may also be involved. Chronic liver disease has also been recognized as an important cause of osteoporosis in both sexes, with the mechanism thought to be a combination of calcium and/or vitamin D. The 9.1% patients with chronic active hepatitis accompanied with osteodystrophy. But 50% cirrhotic patients accompanied with osteodystrophy. Bone densitometry was determined by Digital Image Processing Method (Osteodystrophy < mean-2SD: age- and sex-matched normal value). Serum levels of osteocalcin (BGP) and parathyroid hormone (PTH) in patients of hepatic cirrhosis without osteodystrophy were lower than those with osteodystrophy. These results were suggested that hepatic osteodystrophy was rapidly turnover osteodystrophy. To function physiologically, vitamin D must be hydroxylation in liver to 25-(OH)-D and subsequently by the kidney to 1 alfa, 25-(OH)2-D. Osteodystrophy associated with hepatic cirrhosis is due to a defect in the 1 alfa-hydroxylation by the kidney rather than a hepatic hydroxylation defect. 1 alfa OH-D3 is very useful for treatment for hepatic osteodystrophy.
Collapse
Affiliation(s)
- K Suzuki
- Third Department of Internal Medicine, Nihon University School of Medicine
| | | | | | | |
Collapse
|
35
|
Katoh H, Sugi M, Chino S, Ishige M, Kuroda M, Fujimoto M, Nagai R, Yazaki Y. Development of an immunoradiometric assay kit for ventricular myosin light chain I with monoclonal antibodies. Clin Chem 1992; 38:170-1. [PMID: 1733600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
|
36
|
Nagai R, Isobe M, Yazaki Y, Takaku F, Sugi M, Kato H, Chino S, Saito K. [Clinical application of immunoassays for cardiac myosin light chains]. Rinsho Byori 1989; 37:1353-9. [PMID: 2614965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
We developed four types of immunoassays for cardiac myosin light chains (LC), which are two radioimmunoassays (RIA) for canine and human LC, and an immunoradiometric assay (IRMA) and an enzyme-linked immunosorbent assay (ELISA) for human LC. The first two assays make use of polyclonal antibodies and the last two use monoclonal antibodies. By using these immunoassays, we studied the release of cardiac LC into the serum following acute myocardial infarction (AMI). In experimental AMI in dogs, cardiac LC appeared in the serum within 4-12 hours, reached the maximum at 2-5 days and returned to normal at 7-10 days. This long time-course was suggested due to the continuous liberation of LC from the infarcted myocardium on the basis of a quick disappearance rate of LC from the circulation. The peak LC values were found to correlate well with the histological infarct size. Similar results were also obtained regarding the time-course of circulating LC in clinical patients with AMI. Thus LC measurement seems useful for diagnosis of AMI as well as for estimating the extent of myocardial damage. We also developed an IRMA and an ELISA for human LC by using anti-human LC monoclonal antibodies for a more rapid LC assay and for a consistent supply of antibodies. These assays showed sufficiently high sensitivities to measure 1-100 ng/ml of serum LC. Especially, serum LC can be assayed within 2.5 hours by our ELISA. Such progress in immunoassays for cardiac LC has made the measurement of LC an important laboratory test for the diagnosis of AMI.
Collapse
|
37
|
Chino S, Kaizuka M, Nagayoshi T. Clinical nursing instruction between basic nursing and nursing of adults. Kango Tenbo 1983; 8:63-9. [PMID: 6556422] [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: 04/05/2023]
|
38
|
Chino S, Kaizuke M, Nagayoshi T. [Clinical nursing instruction between basic nursing and adult nursing]. Kango Tenbo 1983; 8:639-49. [PMID: 6557269] [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: 04/05/2023]
|
39
|
Abstract
Hog renal renin-binding protein could bind homologous and non-homologous renin but could not bind human renal renin. Renin-binding protein was only detected in the kidney and pituitary in which renin is found in relatively high concentration. The renal binding protein had no interaction with renal acid proteases nor with extrarenal renins obtained from pituitary and submaxillary glands, indicating that the binding is specific for renal renin. Subcellular localization of the binding protein was studied using rat kidney by differential and density gradient centrifugation. Most renin-binding protein was recovered in the cytosol fraction and was not associated with sedimentable subcellular organelles. A renin-secreting tumor (Juxtaglomerular cell tumor) in human kidney produced not only renin but also renin-binding protein in a very large quantity.
Collapse
|
40
|
Chino S. [American leaders in nursing, an oral history. 5. Eleanor C. Lambertsen]. Kango Tenbo 1980; 5:166-82. [PMID: 6987466] [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: 01/22/2023]
|
41
|
Abstract
This paper presents a previously unrecognized hazard associated with intraaortic balloon pumping: fracture of the catheter due to chemical damage by acetone at the time of removal. Common hospital chemicals such as acetone, ether, and Vi-Drape spray may damage the catheter. Contact between these agents and polyurethane intraaortic balloon catheters should be avoided during dressing changes or repreparation of a sterile operative field. Isopropyl alcohol, Betadine, benzoin, and Cidex do not damage the catheter.
Collapse
|
42
|
Kanda Y, Tai K, Takizawa H, Chino S, Tsuge Y. [Root canal treatment of extracted teeth implanted in plaster using a root canal meter]. Tsurumi Shigaku 1976; 2:25-33. [PMID: 1072928] [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: 12/25/2022]
|
43
|
Chino S. [Memories of my visit to Japan by Miss Quinn, former chief of social and welfare section of the ICN, who advocates improved working and living conditions for nurses]. Kango 1976; 28:126-9. [PMID: 772267] [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: 12/24/2022]
|
44
|
|
45
|
Ihara S, Chino S. [Cytodiagnosis of the lymph]. Gan No Rinsho 1967; 13:757-64. [PMID: 5627451] [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: 01/16/2023]
|
46
|
Kobayashi F, Chino S. [Trends in international nurses' organizations]. Kangogaku Zasshi 1965; 29:22-5. [PMID: 4954915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
47
|
Jawetz E, Chino S, Hanna L. Observations on Incidence and Mechanism of Egg Insusceptibility to Trachoma Viruses. The Journal of Immunology 1962. [DOI: 10.4049/jimmunol.89.1.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Summary
In the fall of 1959 and the summer of 1960 there were periods of a few weeks when embryonated eggs failed to support the growth of trachoma and inclusion conjunctivitis viruses. Yolk sac material harvested from such insusceptible eggs and stored at -40°C for several months interfered with the lethal effect of trachoma virus challenge in susceptible eggs. Quantitation of these phenomena has been attempted and possible explanations proposed. During 1961 careful, frequent tests failed to reveal a period of insusceptibility. Eggs laid during and after a time of extreme heat appeared to be fully susceptible to psittacosis and trachoma viruses. Thus environmental heat and associated nutritional disturbances appear less promising as an explanation for egg insusceptibility than a transmissible, interfering agent.
Collapse
Affiliation(s)
- E. Jawetz
- Department of Microbiology, University of California Medical Center From the , San Francisco, California
| | - S. Chino
- Department of Microbiology, University of California Medical Center From the , San Francisco, California
| | - L. Hanna
- Department of Microbiology, University of California Medical Center From the , San Francisco, California
| |
Collapse
|