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Inoue N, Ohtani H, Morikawa S, Takayama Y, Ogane T, Hiramatsu T, Kumihashi H, Murohara T. Risk of supranormal left ventricular ejection fraction in patients with aortic stenosis. Clin Cardiol 2024; 47:e24255. [PMID: 38469926 PMCID: PMC10928761 DOI: 10.1002/clc.24255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/22/2024] [Accepted: 03/01/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Cardiovascular events are increasing in patients with supranormal left ventricular ejection fraction (snLVEF). However, the effect of snLVEF in patients with aortic stenosis (AS) remains unclear, especially in patients with moderate AS. HYPOTHESIS This study aimed to evaluate the prognosis of mortality and heart failure (HF) in patients with LVEF ≥ 50% and moderate or severe AS. METHODS This retrospective study targeted patients with moderate or severe AS and LVEF > 50%. LVEF of 50%-65% was classified as normal LVEF (nLVEF, nEF group) and >65% as snLVEF (snEF group). AS severity was stratified based on the aortic valve area into moderate (1.0-1.5 cm²) and severe (<1.0 cm²). Primary outcomes included all-cause mortality and HF hospitalization. RESULTS A total of 226 participants were included in this study. There were 67 and 65 participants with moderate AS in snEF (m-snEF) and nEF groups (m-nEF), respectively, and 41 and 53 participants with severe AS in the snEF (s-snEF) and nEF groups (s-nEF), respectively. During the observation period (median: 554 days), the primary composite outcome occurred in 108 individuals. Cox hazard analysis revealed no significant differences among the four groups in primary composite outcomes. With respect to HF hospitalization, the adjusted hazard ratios (95% confidence intervals) with m-snEF as the reference were as follows: m-nEF, 0.41 (0.19-0.89); s-nEF, 1.43 (0.76-2.67); and s-snEF, 1.83 (1.00-3.35). CONCLUSIONS The risk of HF hospitalization for m-snLVEF was higher than m-nLVEF and not significantly different from s-nLVEF.
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Affiliation(s)
- Naoya Inoue
- Department of CardiologyChutoen General Medical Center, KakegawaShizuokaJapan
- Department of CardiologyNagoya University Graduate School of MedicineNagoyaAichiJapan
| | - Hayato Ohtani
- Division of Cardiology, Internal Medicine IIIHamamatsu University School of MedicineShizuokaHamamatsuJapan
| | - Shuji Morikawa
- Department of CardiologyChutoen General Medical Center, KakegawaShizuokaJapan
- Department of CardiologyNagoya University Graduate School of MedicineNagoyaAichiJapan
| | - Yohei Takayama
- Department of CardiologyChutoen General Medical Center, KakegawaShizuokaJapan
- Department of CardiologyNagoya University Graduate School of MedicineNagoyaAichiJapan
| | - Takashi Ogane
- Department of CardiologyChutoen General Medical Center, KakegawaShizuokaJapan
| | - Takehiro Hiramatsu
- Department of CardiologyChutoen General Medical Center, KakegawaShizuokaJapan
- Department of CardiologyNagoya University Graduate School of MedicineNagoyaAichiJapan
| | - Hiroki Kumihashi
- Department of CardiologyChutoen General Medical Center, KakegawaShizuokaJapan
- Department of CardiologyNagoya University Graduate School of MedicineNagoyaAichiJapan
| | - Toyoaki Murohara
- Department of CardiologyNagoya University Graduate School of MedicineNagoyaAichiJapan
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Inoue N, Morikawa S, Ogane T, Hiramatsu T, Murohara T. Clinical value of the fibrosis-4 index in predicting mortality in patients with right ventricular pacing. PLoS One 2024; 19:e0294221. [PMID: 38315703 PMCID: PMC10843135 DOI: 10.1371/journal.pone.0294221] [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] [Received: 10/27/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND The fibrosis-4 (FIB-4) index has attracted attention as a predictive factor for cardiovascular events and mortality in patients with heart disease. However, its clinical value in patients with implanted pacemakers remains unclear. METHODS This study included patients who underwent pacemaker implantation. The FIB-4 index was calculated based on blood tests performed during the procedure. The primary outcome was all-cause mortality, and the secondary outcomes included cardiovascular death, non-cardiovascular death, and major adverse cardiovascular events (MACE; composite of cardiovascular death, heart failure hospitalization, non-fatal myocardial infarction, and non-fatal stroke). The FIB-4 index was stratified into tertiles. Between-group comparisons were performed using log-rank tests and multivariate analysis using Cox proportional hazards. The predictive accuracy and cut-off value of the FIB-4 index were calculated from the receiver operating characteristic curve for all-cause mortality. Finally, based on the calculated cut-off values, the patients were divided into two groups for outcome validation and subgroup analysis. RESULTS This study included 201 participants, of whom 38 experienced death during the observation period (median: 1097 days). All-cause mortality, non-cardiovascular death, and MACE differed significantly between groups stratified by the FIB-4 index tertiles (log-rank test: P<0.001, P<0.001, and P = 0.045, respectively). Using Cox proportional hazards analysis, the unadjusted hazard ratio was 4.75 (95% confidence interval [CI]: 2.05-11.0, P<0.001) for Tertile 3 compared to Tertile 1. After adjustment for confounding factors, including sex, the presence or absence of left bundle branch block at baseline, QRS duration during pacing, and pacing rate at the last check, the hazard ratio was 4.79 (95% CI: 2.04-11.2, P<0.001). The cut-off value of the FIB-4 index was 3.75 (area under the curve: 0.72, 95% CI: 0.62-0.82). CONCLUSIONS In patients with pacemakers, the FIB-4 index may be a predictor of early all-cause mortality, with a cut-off value of 3.75.
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Affiliation(s)
- Naoya Inoue
- Department of Cardiology, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Shuji Morikawa
- Department of Cardiology, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Takashi Ogane
- Department of Cardiology, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan
| | - Takehiro Hiramatsu
- Department of Cardiology, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Inoue N, Ogane T, Hiramatsu T, Morikawa S. Relationship between left-axis deviation and onset of cardiac adverse events in right ventricular pacing. J Electrocardiol 2023; 80:119-124. [PMID: 37327711 DOI: 10.1016/j.jelectrocard.2023.06.002] [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: 04/30/2023] [Revised: 05/29/2023] [Accepted: 06/04/2023] [Indexed: 06/18/2023]
Abstract
AIMS The electrical axis shows alterations during right ventricular pacing (RVP), including a normal axis and left axis deviation; however, it remains unknown if differences in the electrical axis affect the occurrence of cardiac adverse events. The purpose of this study was to determine whether a left axis deviation increases the incidence of adverse cardiac events compared with a normal axis. METHODS This study analysed 156 patients with RVP. The patients were divided into two groups: those with left axis deviation after RVP (LAD group) and those with a normal axis (NA group). The primary composite outcome was the new-onset of atrial fibrillation (AF) and worsening heart failure (HF). RESULTS The QRS axis of the LAD (n = 77) and NA (n = 79) groups were - 64.5 ± 14.3° and 29.8 ± 36.5°, respectively (P < 0.001). The median follow-up was 1100 days and, regarding primary composite outcomes (hazard ratio, 1.03; 95% confidence interval, 0.64 to 1.65; P = 0.89), 29/77 (37.6%) and 28/79 (35.4%) patients in the LAD and NA groups, respectively, developed AF (hazard ratio, 1.07; 95% confidence interval, 0.64 to 1.81; P = 0.77). Furthermore, 8/77 (10.3%) and 12/79 (15.1%) patients in the LAD and NA groups, respectively, experienced worsening HF (hazard ratio, 0.65; 95% confidence interval, 0.26 to 1.60; P = 0.35). CONCLUSION The risk of cardiac adverse events in patients with RVP (new-onset AF or worsening HF, cardiovascular death, myocardial infarction, and stroke) and overall mortality with LAD is not higher than that with NA.
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Affiliation(s)
- Naoya Inoue
- Department of Cardiology, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan; Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
| | - Takashi Ogane
- Department of Cardiology, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan
| | - Takehiro Hiramatsu
- Department of Cardiology, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan; Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Shuji Morikawa
- Department of Cardiology, Chutoen General Medical Center, Kakegawa, Shizuoka, Japan; Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Inoue N, Ohinata R, Mishina T, Kumihashi H, Hiramatsu T, Ogane T, Takayama Y, Morikawa S. Investigation of effective invasive blood pressure control methods to prevent acute exacerbation of acute aortic dissection. Blood Press Monit 2023; 28:123-128. [PMID: 37058077 DOI: 10.1097/mbp.0000000000000647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/15/2023]
Abstract
BACKGROUND Acute aortic dissection is associated with high mortality and increased risk of complications. Acute exacerbations have a relatively high frequency; however, the contributing factors are unclear. Blood pressure (BP) and heart rate control are important factors, but the ideal BP control strategy to prevent acute exacerbations under invasive arterial pressure monitoring remains unclear. Therefore, in this study, we aimed to determine the relationship between invasive arterial BP and the effects of acute exacerbation of aortic dissection. METHODS AND RESULTS This single-centre, retrospective, case-control study included 104 patients with a partial diagnosis of acute aortic dissection (Stanford type A or B) who were treated conservatively between September 2013 and September 2022. The patients were divided into exacerbation (acute exacerbation; n = 26) and stable (no acute deterioration) groups. The SBP trend (122.5 ± 13.1 vs. 116.6 ± 10.6 mmHg, respectively; P = 0.024) and mean BP trend (77.8 ± 5.8 vs. 74.4 ± 7.5 mmHg, respectively; P = 0.038) significantly differed between the two groups. The time to target BP was significantly longer in the exacerbation group (P = 0.036). CONCLUSION The exacerbation group did not achieve a mean SBP < 120 mmHg. Moreover, the importance of early BP reduction was demonstrated in the present study.
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Affiliation(s)
- Naoya Inoue
- Department of Cardiology, Chutoen General Medical Center
- Department of Cardiology, Nagoya University Graduate School of Medicine, Tsurumaicho, Showa-ku, Nagoya, Aichi, Japan
| | - Ryo Ohinata
- Department of Cardiology, Chutoen General Medical Center
| | - Takashi Mishina
- Department of Cardiology, Chutoen General Medical Center
- Department of Cardiology, Nagoya University Graduate School of Medicine, Tsurumaicho, Showa-ku, Nagoya, Aichi, Japan
| | - Hiroki Kumihashi
- Department of Cardiology, Chutoen General Medical Center
- Department of Cardiology, Nagoya University Graduate School of Medicine, Tsurumaicho, Showa-ku, Nagoya, Aichi, Japan
| | - Takehiro Hiramatsu
- Department of Cardiology, Chutoen General Medical Center
- Department of Cardiology, Nagoya University Graduate School of Medicine, Tsurumaicho, Showa-ku, Nagoya, Aichi, Japan
| | - Takashi Ogane
- Department of Cardiology, Chutoen General Medical Center
| | - Yohei Takayama
- Department of Cardiology, Chutoen General Medical Center
- Department of Cardiology, Nagoya University Graduate School of Medicine, Tsurumaicho, Showa-ku, Nagoya, Aichi, Japan
| | - Shuji Morikawa
- Department of Cardiology, Chutoen General Medical Center
- Department of Cardiology, Nagoya University Graduate School of Medicine, Tsurumaicho, Showa-ku, Nagoya, Aichi, Japan
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Yonekawa J, Mizutani Y, Yamashita D, Makino Y, Hiramatsu T, Ichimiya H, Uchida Y, Watanabe J, Kanashiro M. Earliest pulmonary vein potential guided cryoballoon ablation is associated with better clinical outcomes than conventional cryoballoon ablation: a result from two randomized clinical studies. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0361] [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
With regards to short-term outcome in atrial fibrillation (AF), the benefit of cryoballoon ablation (CBA) by pressing a balloon against the earliest pulmonary vein (PV) potential site during pulmonary vein isolation, (earliest potential [EP]-guided CBA) has been previously demonstrated.
Objective
The present study aimed to evaluate the long-term outcome of the EP-guided CBA.
Methods
This study included 136 patients from two randomized studies, who underwent CBA for paroxysmal AF for the first time. Patients were randomly assigned to the EP-guided and conventional CBA groups in each study. In the EP-guided CBA group, we pressed a balloon against the EP site when the time to isolation (TTI) after cryoapplication exceeded 60 s and 45 s in the first and second studies, respectively. The patients were followed up for 1 year after procedure. We compared the clinical outcomes between the EP-guided CBA group (68 patients) and the conventional CBA group (68 patients).
Results
No significant differences in baseline characteristics were observed between the two groups. Compared with the conventional CBA group, the EP-guided CBA group had a significantly higher success rate at TTI ≤90 s (98.5% vs. 90.0%, P<0.001); lower touch-up rate and total cryoapplication; and shorter procedure time, and fluoroscopy time. The recurrence at 1-year after ablation was significantly lower in the EP-guided CBA group than in the conventional CBA group (6.0% vs. 19.4%; P=0.019).
Conclusions
The EP-guided CBA approach can facilitate the ablation procedure and achieve low recurrence at 1-year after ablation.
Funding Acknowledgement
Type of funding sources: None. Earliest potential [EP]-guided CBAThe recurrence at 1-year after ablation
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Affiliation(s)
- J Yonekawa
- Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Y Mizutani
- Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - D Yamashita
- Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Y Makino
- Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - T Hiramatsu
- Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - H Ichimiya
- Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - Y Uchida
- Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - J Watanabe
- Yokkaichi Municipal Hospital, Yokkaichi, Japan
| | - M Kanashiro
- Yokkaichi Municipal Hospital, Yokkaichi, Japan
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Pustogow A, Bories M, Löhle A, Rösslhuber R, Zhukova E, Gorshunov B, Tomić S, Schlueter JA, Hübner R, Hiramatsu T, Yoshida Y, Saito G, Kato R, Lee TH, Dobrosavljević V, Fratini S, Dressel M. Quantum spin liquids unveil the genuine Mott state. Nat Mater 2018; 17:773-777. [PMID: 30082905 DOI: 10.1038/s41563-018-0140-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 06/26/2018] [Indexed: 05/13/2023]
Abstract
The localization of charge carriers by electronic repulsion was suggested by Mott in the 1930s to explain the insulating state observed in supposedly metallic NiO. The Mott metal-insulator transition has been subject of intense investigations ever since1-3-not least for its relation to high-temperature superconductivity4. A detailed comparison to real materials, however, is lacking because the pristine Mott state is commonly obscured by antiferromagnetism and a complicated band structure. Here we study organic quantum spin liquids, prototype realizations of the single-band Hubbard model in the absence of magnetic order. Mapping the Hubbard bands by optical spectroscopy provides an absolute measure of the interaction strength and bandwidth-the crucial parameters that enter calculations. In this way, we advance beyond conventional temperature-pressure plots and quantitatively compose a generic phase diagram for all genuine Mott insulators based on the absolute strength of the electronic correlations. We also identify metallic quantum fluctuations as a precursor of the Mott insulator-metal transition, previously predicted but never observed. Our results suggest that all relevant phenomena in the phase diagram scale with the Coulomb repulsion U, which provides a direct link to unconventional superconductivity in cuprates and other strongly correlated materials.
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Affiliation(s)
- A Pustogow
- Physikalisches Institut, Universität Stuttgart, Stuttgart, Germany.
| | - M Bories
- Physikalisches Institut, Universität Stuttgart, Stuttgart, Germany
| | - A Löhle
- Physikalisches Institut, Universität Stuttgart, Stuttgart, Germany
| | - R Rösslhuber
- Physikalisches Institut, Universität Stuttgart, Stuttgart, Germany
| | - E Zhukova
- Moscow Institute of Physics and Technology (State University), Dolgoprudny, Russia
| | - B Gorshunov
- Moscow Institute of Physics and Technology (State University), Dolgoprudny, Russia
| | - S Tomić
- Institut za fiziku, Zagreb, Croatia
| | - J A Schlueter
- Division of Materials Research, National Science Foundation, Arlington, VA, USA
- Materials Science Division, Argonne National Laboratory, Argonne, IL, USA
| | - R Hübner
- Physikalisches Institut, Universität Stuttgart, Stuttgart, Germany
- Biomedizinische Chemie, Institut für Klinische Radiologie und Nuklearmedizin, Universität Heidelberg, Mannheim, Germany
| | - T Hiramatsu
- Faculty of Agriculture, Meijo University, Nagoya, Japan
| | - Y Yoshida
- Faculty of Agriculture, Meijo University, Nagoya, Japan
- Division of Chemistry, Graduate School of Science, Kyoto University, Kyoto, Japan
| | - G Saito
- Faculty of Agriculture, Meijo University, Nagoya, Japan
- Toyota Physical and Chemical Research Institute, Nagakute, Japan
| | - R Kato
- Condensed Molecular Materials Laboratory, RIKEN, Wako-shi, Saitama, Japan
| | - T-H Lee
- Department of Physics and National High Magnetic Field Laboratory, Florida State University, Tallahassee, FL, USA
| | - V Dobrosavljević
- Department of Physics and National High Magnetic Field Laboratory, Florida State University, Tallahassee, FL, USA
| | - S Fratini
- Institut Néel - CNRS and Université Grenoble Alpes, Grenoble, France
| | - M Dressel
- Physikalisches Institut, Universität Stuttgart, Stuttgart, Germany
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Koshi N, Matsumoto H, Hiramatsu T, Shimizu Y, Hagino H. Influence of backrest angle on swallowing musculature activity and physical strain during the head lift exercise in elderly women compared with young women. J Oral Rehabil 2018; 45:532-538. [PMID: 29761543 DOI: 10.1111/joor.12645] [Citation(s) in RCA: 2] [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] [Accepted: 05/06/2018] [Indexed: 11/27/2022]
Abstract
The head lift exercise (HLE) is the most common exercise for strengthening the swallowing musculature in clinical situations. This study investigated whether a change in the backrest angle of a bed influences swallowing musculature activity and physical strain during the HLE and whether it can generate an appropriate exercise load for swallowing musculature activity for older women compared with younger women. Participants were 10 elderly women and 10 young women, each of whom performed the HLE with a backrest randomly angled at 0°, 15°, 30° and 45°. The activity of the suprahyoid, infrahyoid and sternocleidomastoid muscles was assessed with electromyography. The perception of fatigue was measured with the Borg Rating of Perceived Exertion Scale. The activity of the infrahyoid and sternocleidomastoid muscles in elderly women was significantly lower when the angle of the backrest was raised to 45° vs 0°. In both groups, the Borg rating decreased significantly at the 30° and 45° backrest positions vs the 0° and 15° positions. The activity required for the suprahyoid and infrahyoid muscles in elderly women at a 30° backrest position was almost equal to the activity required by these muscles in young women at a 0° backrest position. In elderly women, it is possible that the HLE with the backrest at a 30° angle may be easier and provide a more appropriate exercise load for strengthening the swallowing muscles.
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Affiliation(s)
- N Koshi
- School of Health Science, Tottori University Graduate School of Medicine, Yonago, Tottori, Japan
| | - H Matsumoto
- Department of Rehabilitation, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Okayama, Japan
| | - T Hiramatsu
- Department of Speech Pathology and Audiology, Tottori City Medical Nursing College, Tottori, Japan
| | - Y Shimizu
- Rehabilitation Division, Tottori University Hospital, Yonago, Tottori, Japan
| | - H Hagino
- Rehabilitation Division, Tottori University Hospital, Yonago, Tottori, Japan.,School of Health Science, Tottori University Faculty of Medicine, Yonago, Tottori, Japan
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Nakanishi K, Tanaka N, Kamei N, Hiramatsu T, Ujigo S, Sumiyoshi N, Rikita T, Takazawa A, Ochi M. Resection of spinous processes can cause spinal cord injury in patient with ossification of the posterior longitudinal ligament in the thoracic spine. Spinal Cord 2014; 52 Suppl 3:S19-21. [DOI: 10.1038/sc.2014.151] [Citation(s) in RCA: 2] [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: 04/30/2014] [Revised: 07/03/2014] [Accepted: 08/01/2014] [Indexed: 11/09/2022]
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Kono N, Ohto U, Hiramatsu T, Urabe M, Uchida Y, Satow Y, Arai H. Impaired -TTP-PIPs Interaction Underlies Familial Vitamin E Deficiency. Science 2013; 340:1106-10. [DOI: 10.1126/science.1233508] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Hiramatsu T, Matsumura G, Konuma T, Yamazaki K, Kurosawa H, Imai Y. Corrigendum to 'Long-term prognosis of double-switch operation for congenitally corrected transposition of the great arteries' [Eur J Cardiothorac Surg 2012;42:1004-08]. Eur J Cardiothorac Surg 2013. [DOI: 10.1093/ejcts/ezs681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Donadio C, Kanaki A, Martin-Gomez A, Garcia S, Palacios-Gomez M, Donadio C, Calia D, Colombini E, DI Francesco F, Ghimenti S, Kanaki A, Onor M, Tognotti D, Fuoco R, Marka-Castro E, Torres Zamora MI, Giron-Mino J, Jaime-Solis MA, Arteaga LM, Romero H, Marka-Castro E, Akonur A, Leypoldt K, Asola M, Culleton B, Eloot S, Glorieux G, Nathalie N, Vanholder R, Perez de Jose A, Verdalles Guzman U, Abad Esttebanez S, Vega Martinez A, Barraca D, Yuste C, Bucalo L, Rincon A, Lopez-Gomez JM, Bataille P, Celine P, Raymond A, Francois G, Herve L, Michel D, Jean Louis R, Zhu F, Kotanko P, Thijssen S, Levin NW, Papamichail N, Bougiakli M, Gouva C, Antoniou S, Gianitsi S, Vlachopanou A, Chachalos S, Naka K, Kaarsavvidou D, Katopodis K, Michalis L, Sasaki K, Yasuda K, Yamato M, Surace A, Rovatti P, Steckiph D, Bandini R, Severi S, Dellacasa Bellingegni A, Santoro A, Arias M, Arias M, Sentis A, Perez N, Fontsere N, Vera M, Rodriguez N, Arcal C, Ortega N, Uriza F, Cases A, Maduell F, Abbas SR, Abbas SR, Zhu F, Kotanko P, Levin NW, Georgianos P, Sarafidis P, Nikolaidis P, Lasaridis A, Ahmed A, Ahmed A, Kaoutar H, Mohammed B, Zouhir O, Balter P, Ginsberg N, Taylor P, Sullivan T, Usvyat LA, Levin NW, Kotanko P, Zabetakis P, Moissl U, Ferrario M, Garzotto F, Wabel P, Cruz D, Tetta C, Signorini MG, Cerutti S, Brendolan A, Ronco C, Heaf J, Axelsen M, Pedersen RS, Ahmed A, Ahmed A, Amine H, Oualim Z, Ammirati AL, Guimaraes de Souza NK, Nemoto Matsui T, Luiz Vieira M, Alves de Oliveira WA, Fischer CH, Dias Carneiro F, Iizuka IJ, Aparecida de Souza M, Mallet AC, Cruz Andreoli MC, Cardoso Dos Santos BF, Rosales L, Dou Y, Carter M, Thijssen S, Kotanko P, Testa A, Sottini L, Giacon B, Prati E, Loschiavo C, Brognoli M, Marseglia C, Tommasi A, Sereni L, Palladino G, Bove S, Bosticardo G, Schillaci E, Detoma P, Bergia R, Park JW, Moon SJ, Choi HY, Ha SK, Park HC, Liao Y, Zhang L, Fu P, Igarashi H, Suzuki N, Esashi S, Masakane I, Panichi V, De Ferrari G, Saffiotti S, Sidoti A, Biagioli M, Bianchi S, Imperiali P, Gabrielli C, Conti P, Patrone P, Rombola G, Falqui V, Mura C, Icardi A, Rosati A, Santori F, Mannarino A, Bertucci A, Steckiph D, Jeong J, Jeong J, Kim OK, Kim NH, Bots M, Den Hoedt C, Grooteman MP, Van der Weerd NC, Mazairac AHA, Levesque R, Ter Wee PM, Nube MJ, Blankestijn P, Van den Dorpel MA, Park Y, Jeon J, Tessitore N, Tessitore N, Bedogna V, Girelli D, Corazza L, Jacky P, Guillaume Q, Julien B, Marcinkowski W, Drozdz M, Milkowski A, Rydzynska T, Prystacki T, August R, Benedyk-Lorens E, Bladek K, Cina J, Janiszewska G, Kaczmarek A, Lewinska T, Mendel M, Paszkot M, Trafidlo E, Trzciniecka-Kloczkowska M, Vasilevsky A, Konoplev G, Lopatenko O, Komashnya A, Visnevsky K, Gerasimchuk R, Neivelt I, Frorip A, Vostry M, Racek J, Rajdl D, Eiselt J, Malanova L, Pechter U, Selart A, Ots-Rosenberg M, Krieter DH, Seidel S, Merget K, Lemke HD, Wanner C, Krieter DH, Canaud B, Lemke HD, Rodriguez A, Morgenroth A, Von Appen K, Dragoun GP, Wanner C, Fluck R, Fouque D, Lockridge R, Motomiya Y, Uji Y, Hiramatsu T, Ando Y, Furuta M, Furuta M, Kuragano T, Kida A, Yahiro M, Otaki Y, Hasuike Y, Nonoguchi H, Nakanishi T, Sain M, Sain M, Kovacic V, Ljutic D, Radic J, Jelicic I, Yalin SF, Yalin SF, Trabulus S, Yalin AS, Altiparmak MR, Serdengecti K, Ohtsuka A, Fukami K, Ishikawa K, Ando R, Kaida Y, Adachi T, Sugi K, Okuda S, Nesterova OB, Nesterova OB, Suglobova ED, Golubev RV, Vasiliev AN, Lazeba VA, Smirnov AV, Arita K, Kihara E, Maeda K, Oda H, Doi S, Masaki T, Hidaka S, Ishioka K, Oka M, Moriya H, Ohtake T, Nomura S, Kobayashi S, Wagner S, Gmerek A, Wagner J, Wizemann V, Eftimovska - Otovic N, Spaseska-Gjurovska K, Bogdanovska S, Babalj - Banskolieva E, Milovanceva M, Grozdanovski R, Pisani A, Riccio E, Mancini A, Ambuhl P, Astrid S, Ivana P, Martin H, Thomas K, Hans-Rudolf R, Daniel A, Denes K, Marco M, Wuthrich RP, Andreas S, Andrulli S, Altieri P, Sau G, Bolasco P, Pedrini LA, Basile C, David S, Feriani M, Nebiolo PE, Ferrara R, Casu D, Logias F, Tarchini R, Cadinu F, Passaghe M, Fundoni G, Villa G, DI Iorio BR, Zoccali C, Locatelli F, Kihara E, Arita K, Hamamoto M, Maeda K, Oda H, Doi S, Masaki T, Lee DY, Kim B, Moon KH, LI Z, Fu P, Ahrenholz P, Ahrenholz P, Winkler RE, Waitz G, Wolf H, Grundstrom G, Alquist M, Holmquist M, Christensson A, Bjork P, Abdgawad M, Ekholm L, Segelmark M, Corsi C, Santoro A, De Bie J, Mambelli E, Mortara D, Santoro A, Severi S, Arroyo D, Arroyo D, Panizo N, Quiroga B, Reque J, Melero R, Rodriguez-Ferrero M, Rodriguez-Benitez P, Anaya F, Luno J, Ragon A, James A, Brunet P, Ribeiro S, Faria MS, Rocha S, Rodrigues S, Catarino C, Reis F, Nascimento H, Fernandes J, Miranda V, Quintanilha A, Belo L, Costa E, Santos-Silva A, Arund J, Tanner R, Fridolin I, Luman M, Clajus C, Clajus C, Kielstein JT, Haller H, David S, Basile C, Basile C, Libutti P, Lisi P, Vernaglione L, Casucci F, Losurdo N, Teutonico A, Lomonte C, Krisp C, Gmerek A, Wagner J, Wolters DA, Pedrini LA, Matsuyama M, Tomo T, Ishida K, Matsuyama K, Nakata T, Kadota J, Caiazzo M, Monari E, Cuoghi A, Bellei E, Bergamini S, Palladino G, Tomasi A, Baranger T, Seniuta P, Berge F, Drouillat V, Frangie C, Rosier E, Labonia W, Lescano A, Rubio D, Von der Lippe N, Jorgensen JA, Osthus TB, Waldum B, Os I, Bossola M, DI Stasio E, Antocicco M, Tazza L, Griveas I, Karameris A, Pasadakis P, Savica V, Santoro D, Saitta S, Tigano V, Bellinghieri G, Gangemi S, Daniela R, Checherita IA, Ciocalteu A, Vacaroiu IA, Niculae A, Bladek K, Stefaniak E, Pietrzak I, Krupa D, Garred L, Santoro A, Mancini E, Corrazza L, Atti M, Afsar B, Stamopoulos D, Mpakirtzi N, Gogola B, Zeibekis M, Stivarou D, Panagiotou M, Grapsa E, Vega Vega O, Barraca Nunez D, Abad Esttebanez S, Bucalo L, Yuste C, Lopez-Gomez JM, Fernandez-Lucas M, Gomis A, Teruel JL, Elias S, Quereda C, Hignell L, Humphrey S, Pacy N, Stamopoulos D, Mpakirtzi N, Afentakis N, Grapsa E. Extracorporeal dialysis: techniques and adequacy. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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12
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Tanaka T, Ishihara Y, Takabayashi N, Kobayashi R, Hiramatsu T, Kuriki K. Gastrointestinal: asymptomatic colonic schwannoma in an elderly woman; a rare case. J Gastroenterol Hepatol 2011; 26:1339. [PMID: 21771061 DOI: 10.1111/j.1440-1746.2011.06677.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- T Tanaka
- Department of Surgery, Yaizu Municipal Hospital, Shizuoka, Japan Department of Pathology, Yaizu Municipal Hospital, Shizuoka, Japan
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13
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Kotani H, Kishi R, Mouri A, Sashio T, Shindo J, Shiraki A, Hiramatsu T, Iwata S, Taniguchi H, Nishiyama O, Iwata M, Suzuki R, Gonda H, Niwa T, Kondo M, Hasegawa Y, Kume H, Noda Y. Influence of leukotriene pathway polymorphisms on clinical responses to montelukast in Japanese patients with asthma. J Clin Pharm Ther 2011; 37:112-6. [PMID: 21385196 DOI: 10.1111/j.1365-2710.2011.01248.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Montelukast, a cysteinyl leukotriene receptor 1 antagonist, is safe and efficacious in patients with asthma. The mechanisms underlying the significant interpatient variability in response to montelukast are not clear but are believed to be, in part, because of genetic variability. METHODS To examine the associations between polymorphisms in candidate genes in the leukotriene pathway and outcomes in patients with asthma on montelukast for 4-8 weeks, we evaluated the changes in peak expiratory flow (PEF), forced expiratory volume in 1 s (FEV(1·0) ) and patients' subjective symptom before and after montelukast treatment. DNA was collected from 252 Japanese participants. RESULTS AND DISCUSSION Two single-nucleotide polymorphisms (SNPs) in the ALOX5 (rs2115819) and LTA4H (rs2660845) genes were successfully typed. There was no difference between members of the general population (n = 200) and patients (n = 52) in each genotype frequency. Significant associations were found between SNP genotypes in the LTA4H gene and changes in PEF and FEV(1·0) . The PEF and FEV(1·0) responses to montelukast in the A/A genotypes (n = 4) for the LTA4H SNP were significantly higher than those in the G allele carriers (A/G+G/G) (n = 17). WHAT IS NEW AND CONCLUSION Despite the small sample size, our results suggest that genetic variation in leukotriene pathway candidate genes contributes to variability in clinical responses to montelukast in Japanese patients with asthma.
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Affiliation(s)
- H Kotani
- Division of Clinical Sciences and Neuropsychopharmacology, Meijo University Graduate School of Pharmaceutical Sciences, Nagoya, Japan
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14
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Ohki M, Kitazawa H, Hiramatsu T, Kaga K, Kitamura T, Yamada J, Nagao S. Role of Primate Cerebellar Hemisphere in Voluntary Eye Movement Control Revealed by Lesion Effects. J Neurophysiol 2008. [DOI: 10.1152/jn.90440.2009] [Citation(s) in RCA: 3] [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] [Indexed: 11/22/2022] Open
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15
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Kawamura S, Ando M, Nakamura T, Tsubono K, Tanaka T, Funaki I, Seto N, Numata K, Sato S, Ioka K, Kanda N, Takashima T, Agatsuma K, Akutsu T, Akutsu T, Aoyanagi KS, Arai K, Arase Y, Araya A, Asada H, Aso Y, Chiba T, Ebisuzaki T, Enoki M, Eriguchi Y, Fujimoto MK, Fujita R, Fukushima M, Futamase T, Ganzu K, Harada T, Hashimoto T, Hayama K, Hikida W, Himemoto Y, Hirabayashi H, Hiramatsu T, Hong FL, Horisawa H, Hosokawa M, Ichiki K, Ikegami T, Inoue KT, Ishidoshiro K, Ishihara H, Ishikawa T, Ishizaki H, Ito H, Itoh Y, Kamagasako S, Kawashima N, Kawazoe F, Kirihara H, Kishimoto N, Kiuchi K, Kobayashi S, Kohri K, Koizumi H, Kojima Y, Kokeyama K, Kokuyama W, Kotake K, Kozai Y, Kudoh H, Kunimori H, Kuninaka H, Kuroda K, Maeda KI, Matsuhara H, Mino Y, Miyakawa O, Miyoki S, Morimoto MY, Morioka T, Morisawa T, Moriwaki S, Mukohyama S, Musha M, Nagano S, Naito I, Nakagawa N, Nakamura K, Nakano H, Nakao K, Nakasuka S, Nakayama Y, Nishida E, Nishiyama K, Nishizawa A, Niwa Y, Ohashi M, Ohishi N, Ohkawa M, Okutomi A, Onozato K, Oohara K, Sago N, Saijo M, Sakagami M, Sakai SI, Sakata S, Sasaki M, Sato T, Shibata M, Shinkai H, Somiya K, Sotani H, Sugiyama N, Suwa Y, Tagoshi H, Takahashi K, Takahashi K, Takahashi T, Takahashi H, Takahashi R, Takahashi R, Takamori A, Takano T, Taniguchi K, Taruya A, Tashiro H, Tokuda M, Tokunari M, Toyoshima M, Tsujikawa S, Tsunesada Y, Ueda KI, Utashima M, Yamakawa H, Yamamoto K, Yamazaki T, Yokoyama J, Yoo CM, Yoshida S, Yoshino T. The Japanese space gravitational wave antenna - DECIGO. ACTA ACUST UNITED AC 2008. [DOI: 10.1088/1742-6596/122/1/012006] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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16
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Kaneko M, Hiramatsu T, Nishimura Y, Iwahashi M, Komori S, Shibata M, Yuzaki M, Okamura Y, Suzuki H, Takeuchi T, Shibuta S. [Effects of octreotide acetate on intractable chylothorax after surgery for congenital heart diseases]. Kyobu Geka 2006; 59:561-4. [PMID: 16856532] [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: 05/10/2023]
Abstract
We experienced 2 infants in whom octreotide acetate was effective on intractable chylothorax after surgery for congenital heart diseases. They were 8- and 5-month-old. They were diagnosed as having corrected transposition of the great arteries (TGA) and tetralogy of Fallot respectively, and underwent bidirectional Glenn anastomosis and right modified Blalock Taussig shunt. Chylothorax was revealed on the 11th and the 1st postoperative day, and was not improved by any conventional therapy in either case. Then octreotide acetate was infused continuously with 0.1-0.6 micorg/kg/hour for 24 and 7 days. Chylothorax disappeared completely without any complications such as disturbance of blood sugar level or growth retardation. Octreotide acetate was effective and safe even in infants in intractable chylothorax after surgery for congenital heart diseases, as long as used for short period.
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Affiliation(s)
- M Kaneko
- Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, Wakayama, Japan
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Hiramatsu T, Okamura Y, Komori S, Nishimura Y, Iwahashi M, Shibata M, Yuzaki M, Suzuki H, Takeuchi T, Shibuta S. [Effects of additional pulmonary blood flow after bidirectional Glenn procedure]. Kyobu Geka 2006; 59:373-6. [PMID: 16715887] [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: 05/09/2023]
Abstract
Thirteen cases of functional single ventricle who had undergone bidirectional Glenn procedure were divided into 2 groups according to presence (5) or absence (8) of additional pulmonary blood flow. Additional flow was preserved in cases with relatively small pulmonary artery index (PA index), and their sources were antegrade pulmonary blood flow (2), and Blalock-Taussig (BT) shunt (3). In the control group, PA index was reduced to about 70% of the preoperative value, while in the additional group, pulmonary artery growth was recognized without significant elevation of mean pulmonary artery pressure. However, atrioventricular valve regurgitation progressed and systemic ventricular volume did not decrease after Glenn in the additional group. Therefore special consideration for the timing of Fontan procedure is mandatory.
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Affiliation(s)
- T Hiramatsu
- Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, Wakayama, Japan
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18
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Naito Y, Harada Y, Hiramatsu T, Uchita S, Masuhara H, Honda Y, Satomi G, Yasukochi S, Matsui H. [Staged surgical palliations for hypoplastic left heart syndrome with poor preoperative conditions]. Kyobu Geka 2005; 58:1145-8. [PMID: 16359014] [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: 05/05/2023]
Abstract
A 2.8 kg-female newborn diagnosed as hypoplastic left heart syndrome was transferred to our hospital after resuscitation against systemic circulatory failure due to closure of the ductus arteriosus. Her systemic circulation was stabilized after alprostadil (lipo-PGE1) and inotorpic agent infusion along with mechanical ventilation support. On admission, signs of a pulmonary high-flow and low systemic perfusion were evident. Impaired coagulation aspect was gradually noted. Because a surgical palliation with cardiopulmonary bypass was considered to be at high-risk, a bilateral pulmonary artery banding was indicated. Through a median sternotomy, the right and left pulmonary arteries were individually banded. The patient was continued on the same ventilation strategy. Cardiac, hepatic and renal dysfunctions were improved over next few days and the patient weaned from ventilatory support. She underwent combined Norwood stage I and II repair at 4 months of age with weight of 4.8 kg. Postoperative course has been uneventful and the patient is now followed up in preparation for Fontan operation.
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Affiliation(s)
- Yuji Naito
- Yuji Naito et al., Department of Cardiovascular Surgery, Nagano Children's Hospital, Azumino, Japan
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Komori S, Hiramatsu T, Okamura Y, Nishimura H, Mori H, Hayashi H, Suzuki H, Takeuchi T. [Blalock-Taussig shunt and pulmonary artery angioplasty for isolated unilateral absence of the right pulmonary artery; report of a case]. Kyobu Geka 2005; 58:1069-72. [PMID: 16281858] [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: 05/05/2023]
Abstract
A 7-month-old girl was referred to us for further examination of absence of the right pulmonary artery. She had no symptom at that time. Diagnosis was made by chest computed tomography (CT) and cardiac catheterization. Though the size of the right pulmonary artery was not apparent, right pulmonary vein wedge angiography revealed the distal portion of right pulmonary artery sufficient for surgical repair. But the distance between the pulmonary trunk and right pulmonary artery was too far to perform direct anastomosis, and some systemic collaterals had already been recognized. Pulmonary vasculature was also not inadequate. Therefore we planned a palliative procedure. At the age of 7 months, right modified Blalock-Tausig shunt using 5mm expand-polytetrafluoroethylene (ePTFE) tube and angioplasty of the distal portion of right pulmonary artery using autologous pericardium roll with Dacron mesh was performed. Postoperative course was uneventful. She has been followed up for 6 months after the palliation. In the near future the completion of the definitive repair will be considered.
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Affiliation(s)
- S Komori
- Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, Wakayama, Japan
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Hiramatsu T, Harada Y, Hibino N, Masuhara H, Honda Y, Satomi G, Yasukochi S, Matsui H, Otokozawa K, Kajiyama Y, Kitamura M. [Comparison of right ventricular function between prevention and enlargement of pulmonary valve annulus after repair of tetralogy of Fallot; mid-term results]. Kyobu Geka 2005; 58:1049-52. [PMID: 16281854] [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: 05/05/2023]
Abstract
Total of 41 patients with tetralogy of Fallot (TOF) who underwent intracardiac repair from 1993 to 1998 were divided into 2 groups: preservation (n = 14) or enlargement (n = 27) of the pulmonary valve annulus. The procedure was decided on the Z value of the annular size: above or under -2 SD of the standard value. Although postoperative right ventricular (RV) diastolic volume (RVEDV) and cardiothoracic ratio (CTR) were larger than the preservation group and pulmonary regurgitation (PR) existed in the enlargement group, RV pressure was decreased and central venous pressure (CVP) was low and RV contraction was preserved. The exercise capacity was also good and no significant arrhythmia was recognized. Our mid-term results showed that appropriate enlargement of the pulmonary valve annulus preserved good RV function in patients with TOF.
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Affiliation(s)
- T Hiramatsu
- Department of Cardiovascular Surgery, Nagano Children's Hospital, Japan
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21
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Hayashi H, Nishimura Y, Mori H, Komori S, Hiramatsu T, Okamura Y. [Sutureless technique for oozing type postinfarction left ventricular free wall rupture]. Kyobu Geka 2005; 58:267-70. [PMID: 15828244] [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: 05/02/2023]
Abstract
We report our experience using a sutureless technique for oozing type postinfarction left ventricular free wall rupture. Several materials such as fibrin seat, autologous or heterologous pericardial patch, fibrin glue, and geratin-resorcin-formaldehyde (GRF) glue have been used. Nine patients, who developed postinfarction left ventricular free wall rupture, underwent surgical repair using a sutureless technique between 1999 and 2004. All patients survived and discharged our hospital without any postoperative complications. And all are alive an exellent condition in 5 to 44 months. A sutureless technique for the treatment of oozing type postinfarction left ventricular free wall rupture is simple, effective, and associated with a favorable outcome.
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Affiliation(s)
- Hiroki Hayashi
- Department of Thoracic and Cardiovascular Surgery, Wakayama Medical University, Wakayama, Japan
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Masuhara H, Hiramatsu T, Harada Y, Hibino N, Honda Y, Satomi G, Yasukochi S, Matsui H, Otokozawa K, Kitamura M, Kajiyama Y. [Congenital supravalvular aortic stenosis; report of a case]. Kyobu Geka 2004; 57:1135-8. [PMID: 15553032] [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: 05/01/2023]
Abstract
We experienced a successful surgical case of extended aortoplasty by means of Doty's method (two sinus reconstruction) for congenital supravalvular aortic stenosis (SAS). Case was 12-year-old boy, who had no complaint except heart murmur. The retrograde aortography demonstrated localized stenosis just above the aortic valve, and it was an hour-glass type. The preoperative peak systolic pressure gradient between the left ventricle and ascending aorta was 56 mmHg, which was improved postoperatively. This case showed excellent results. Doty's aortoplasty was favorable method for SAS without deformity of aortic valve and coronary obstruction.
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Affiliation(s)
- Hiroshi Masuhara
- Department of Cardiovascular Surgery, Nagano Children's Hospital, Nagano, Japan
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Suzuki R, Taniguchi H, Kondoh Y, Shindoh J, Matsumoto S, Hiramatsu T, Gonda H, Baba K, Hasegawa Y, Shimokata K. A phase II trial of concurrent radiochemotherapy with carboplatin (CBDCA) and weekly docetaxel (TXT) in locally advanced non-small cell lung cancer (NSCLC). J Clin Oncol 2004. [DOI: 10.1200/jco.2004.22.90140.7174] [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: 11/20/2022] Open
Affiliation(s)
- R. Suzuki
- Central Japan Lung Study Group, Nagoya, Aichi, Japan
| | - H. Taniguchi
- Central Japan Lung Study Group, Nagoya, Aichi, Japan
| | - Y. Kondoh
- Central Japan Lung Study Group, Nagoya, Aichi, Japan
| | - J. Shindoh
- Central Japan Lung Study Group, Nagoya, Aichi, Japan
| | - S. Matsumoto
- Central Japan Lung Study Group, Nagoya, Aichi, Japan
| | - T. Hiramatsu
- Central Japan Lung Study Group, Nagoya, Aichi, Japan
| | - H. Gonda
- Central Japan Lung Study Group, Nagoya, Aichi, Japan
| | - K. Baba
- Central Japan Lung Study Group, Nagoya, Aichi, Japan
| | - Y. Hasegawa
- Central Japan Lung Study Group, Nagoya, Aichi, Japan
| | - K. Shimokata
- Central Japan Lung Study Group, Nagoya, Aichi, Japan
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Takeuchi M, Hayakawa A, Takagi K, Hiramatsu K, Shimizu Y, Matsumoto S, Hiramatsu T, Ito Y, Kume H, Suzuki R, Yamaki K. Theophylline induces apoptosis of the IL-3 activated eosinophils of patients with bronchial asthma. Apoptosis 2003; 4:461-8. [PMID: 14634331 DOI: 10.1023/a:1009656527168] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
In bronchial asthma, eosinophils are upregulated and their survival is suggested to be prolonged by the action of some cytokines such as Interleukin (IL)-3, IL-5 and granulocyte-macrophage colony-stimulating factor (GM-CSF). We find here that the survival of eosinophils in the peripheral blood of patients with asthma is correlated with the serum levels of IL-3 but not of IL-5 and GM-CSF. Interestingly, theophylline is revealed to induce apoptosis of the prolonged survival eosinophils by IL-3, as judged by morphological changes and nucleosomal DNA fragmentation. During the apoptosis, caspase-3 in eosinophils stimulated by IL-3 is activated by theophylline. The substrate of caspase-3, poly (ADP-ribose) polymerase (PARP), is cleaved in the eosinophils after theophylline treatment. These results suggest that theophylline is able to induce apoptosis of the IL-3 activated eosinophils in patients with bronchial asthma, and that its clinical effectiveness may be due to the reduction of inflammatory cells in the airway.
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Affiliation(s)
- M Takeuchi
- Second Department of Internal Medicine, Nagoya University School of Medicine, Nagoya, Japan
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Uchikawa S, Imai Y, Aoki M, Shin'oka T, Hiramatsu T, Ota J, Nagashima M, Tei I. [Repair for atrioventricular valve regurgitation using autologous pericardium: report of a case]. Kyobu Geka 2003; 56:565-8. [PMID: 12854464] [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: 03/03/2023]
Abstract
A 13-year-old boy with [SLL] single left ventricle first underwent ventricular septation using a dacron patch at 3 years of age. Eight years after the first surgery, he presented with general fatigue on exertion as the chief complaint. Right-sided atrioventricular valve regurgitation, and dilatation of the right heart were diagnosed. Eleven years after surgery, right heart failure was uncontrollable by medicine, and 2nd surgery was performed. At operation, the right-sided heart valve leaflet was tightly adherent to the dacron septation patch, and valve plasty was judged impossible. We repaired the right-sided atrioventricular valve using an autologous pericardial valve leaflet and sub-valvular tissue. The postoperative course was uneventful, and he has been free from any complication for 33 months.
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Affiliation(s)
- S Uchikawa
- Department of Pediatric Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan
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26
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Matsumura G, Imai Y, Seo K, Aoki M, Shin-oka T, Hiramatsu T, Ohta J, Hagino I, Kashiwagi J, Ishiyama M, Satoh K, Okamura T. [A case report of ross operation and ventricular septal defect closure following correction of type A interruption by modified Blalock-Park, pulmonary artery banding and patent ductus arteriosus division]. Kyobu Geka 2002; 55:243-8. [PMID: 11889814] [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: 02/24/2023]
Abstract
A 2-year-old boy who had undergone a correction of a type A interruption using a modified Blalock-Park operation, pulmonary artery banding and the division of a patent ductus arteriosus, underwent a Ross operation and closure of ventricular septal defect (VSD). Although a pre-operative echo cardiogram revealed a bicuspid aortic valve, and a Doppler echocardiogram showed only 10 mmHg of pressure gradient across the aortic valve, Ross procedure was performed as a procedure accompanying the closure of a total conus VSD. The total conus VSD was closed with a Dacron patch using pledget mattress sutures. In addition, a running suture was applied over the denuded aortic root and the cranial margin to achieve water tight closure. An aortic root replacement procedure was our first choice for the Ross operation. After both coronary buttons were re-implanted into pulmonary sinuses, a pulmonary artery autograft was wrapped around by the remaining aortic wall for reinforcement to prevent future dilatation. The main pulmonary artery was reconstructed using a bicuspid pericardial valve conduit with a diameter of 24 mm. A post-operative echocardiogram showed no neoaortic valve regurgitation, good coaptation of tri-leaflets, mild regurgitation of pericardial valve and good cardiac performance.
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Affiliation(s)
- G Matsumura
- Department of Pediatric Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan
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Murata A, Imai Y, Seo K, Aoki M, Shin-oka T, Hiramatsu T, Oota J, Kashiwagi J, Hagino I, Ishiyama M, Sato K, Okamura T. [A modified Fontan operation in the presence of a supracardiac total anomalous pulmonary venous connection]. Kyobu Geka 2002; 55:257-9. [PMID: 11889817] [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: 02/24/2023]
Abstract
We report a case of 2-year-old girl with asplenia syndrome who successfully underwent modified Fontan procedure and concomitant repair of supracardiac total anomalous pulmonary venous connection (TAPVC). The preoperative diagnosis included a common atrioventricular canal (type C), a double outlet right ventricle, a common atrium, common atrioventricular valve regurgitation, pulmonary stenosis, and a bilateral superior vena cava (SVC). Cardiac catheterization revealed a Qp/Qs of 1.3, mean PA pressure of 16 mmHg and an Rp of 1.3. The TAPVC drained to left SVC (LSVC) at a position proximal to the hemiazygos vein with an ostium of 5 mm in diameter. The LSVC was divided distal to its connection to the common pulmonary vein (CPV). The TAPVC ostium was cut back into the CPV, then it was anastmosed with posterior aspect of the atrial wall in an effort to provide a wide anastomosis. The postoperative course was uneventful and the patient was discharged from hospital on the 35th postoperative day.
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Affiliation(s)
- A Murata
- Department of Pediatric Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan
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Abstract
Superior-inferior ventricles are a rare cardiac malformation characterized by the two ventricles lying one above the other instead of side by side. Consequently, the interventricular septum that separates such ventricles is horizontal, and anomalies of the atrioventricular valves and the ventriculoarterial relations are almost always present. This complex anomaly is difficult to manage with an operation, so few cases have been reported. We describe a successful experience in which we performed a double switch operation, consisting of the Senning and Jatene procedures, for this rare malformation accompanied by double-outlet right ventricle [S,L,L]. This is the first report we have been able to locate of a double switch operation for superior-inferior ventricles.
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Affiliation(s)
- N Hibino
- Department of Pediatric Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical College
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Gouda T, Kuroda M, Hiramatsu T, Nozaki K, Kuroda T, Mizushima T, Tsuchiya T. nhaG Na(+)/H(+) antiporter gene of Bacillus subtilis ATCC9372, which is missing in the complete genome sequence of strain 168, and properties of the antiporter. J Biochem 2001; 130:711-7. [PMID: 11686935 DOI: 10.1093/oxfordjournals.jbchem.a003038] [Citation(s) in RCA: 25] [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] [Indexed: 11/13/2022] Open
Abstract
We cloned a gene which enabled Escherichia coli mutant host cells lacking all of the major Na(+)/H(+) antiporters to grow in the presence of 0.2 M NaCl from chromosomal DNA of Bacillus subtilis ATCC9372. An Na(+)/H(+) antiport activity was observed with membrane vesicles prepared from E. coli cells possessing the cloned gene, but not with vesicles from the host cells. Lithium ion was also a substrate for the antiporter. We sequenced the cloned DNA and found one open reading frame (designated nhaG) preceded by a promoter-like sequence and a Shine-Dalgarno sequence, and followed by a terminator-like sequence. The deduced amino acid sequence of NhaG suggested that it consisted of 524 residues and that the calculated molecular mass was 58.1 kDa. None of the bacterial Na(+)/H(+) antiporters so far reported, except NhaP of Pseudomonas aeruginosa and SynNhaP (NhaS1) of Synechocystis sp., showed significant sequence similarity with the NhaG. However, the NhaP, the SynNhaP, animal NHEs (Na(+)/H(+) exchangers), and some hypothetical Na(+)/H(+) antiporters of several organisms showed significant sequence similarities with the NhaG. Interestingly, the entire DNA region corresponding to the nhaG gene is missing in the reported complete genome sequence of B. subtilis strain 168. We detected a band that hybridized with the nhaG DNA in chromosomal DNA from B. subtilis ATCC9372 but not with that from strain 168. The missing DNA region (1,774 base pairs) is sandwiched by two identical sequences, TTTTCTT.
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Affiliation(s)
- T Gouda
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Okayama University, Tsushima, Okayama, 700-8530, Japan
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30
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Ishida T, Imai Y, Hoshino S, Hiramatsu T, Seo K, Aoki M, Shin'oka S. [Case report of CABG for progressive coronary artery stenosis after 22-year history of Kawasaki disease]. Kyobu Geka 2001; 54:859-62. [PMID: 11554077] [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: 02/21/2023]
Abstract
More than 30 years has passed since Kawasaki disease was recognized as an independent disease entity, but the cardiovascular complications of Kawasaki disease are still not well known. We report an 22-year-old woman who underwent triple coronary artery bypass grafting because of a coronary artery aneurysm and multiple coronary artery stenoses, 22 years after the diagnosis of Kawasaki disease. A 2 cm coronary artery aneurysm due to Kawasaki disease was diagnosed when she was 10 years old, when she first presented with the symptom of dyspnea on effort. Since then, she was followed at the outpatient clinic. When she was 19 years old, the first coronary catheterization was performed. Two years later, the second coronary catheterization revealed progression of coronary artery disease. Therefore, coronary artery bypass grafting was performed. This case is rare from the point of view of long-term progression of coronary artery disease.
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Affiliation(s)
- T Ishida
- Department of Pediatric Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan
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Aoki K, Nakanou I, Takashima K, Hirao K, Hiramatsu T, Fujimoto K, Kagebayashi Y, Ozono S, Hirao Y. [A case of renal cell carcinoma producing alpha-fetoprotein]. Hinyokika Kiyo 2001; 47:477-80. [PMID: 11523131] [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: 02/21/2023]
Abstract
Renal cell carcinoma (RCC) producing alpha-fetoprotein (AFP) is a rare condition with only 11 cases reported in Japan to our knowledge. A 69-year-old man was admitted to our hospital for further examination of an incidental right renal tumor. Laboratory tests showed markedly increased serum level of AFP whereas both HBs antigen and anti-HCV antibody were negative. Computed tomography and magnetic resonance imaging imagings showed a right renal tumor but no tumor in liver, testis or lymph node. We performed right radical nephrectomy. Serum level of AFP declined within the normal range 7 weeks after nephrectomy according to its half-life curve. The tumor specimen was composed mainly of granular cells. Immunohistochemical examination of the tumor cells proved the presence of AFP in the cytoplasm. The possibility of AFP as a tumor marker of renal cell carcinoma in this case was presented.
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Affiliation(s)
- K Aoki
- Department of Urology, Hirao Hospital
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Saito T, Kumagai Y, Hiramatsu T, Kurosawa M, Sato T, Habu S, Mitsui K, Kodera Y, Hiroto M, Matsushima A, Inada Y, Nishimura H. Immune tolerance induced by polyethylene glycol-conjugate of protein antigen: clonal deletion of antigen-specific Th-cells in the thymus. J Biomater Sci Polym Ed 2001; 11:647-56. [PMID: 10981679 DOI: 10.1163/156856200743922] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Polyethylene glycol (PEG) conjugates of protein antigens induce antigen-specific immune tolerance of helper T (Th)-cells. However, the mechanism of this Th-cell tolerance has remained unelucidated. Using transgenic mice with ovalbumin (OVA)-specific T-cell receptor (TCR) genes, we examined the response of OVA-specific Th-cells towards tolerogenic PEG-conjugate of OVA in vitro and in vivo. When stimulated with PEG--OVA in vitro, transgenic OVA-specific Th-cells proliferated and produced interleukin 2, the levels of which were comparable to those induced by unmodified OVA. In contrast, PEG--OVA administered into the circulation of transgenic mice induced unresponsiveness in peripheral OVA-specific Th-cells. Moreover, in the thymus of these transgenic mice, the frequency of immature CD4+CD8+ (double positive) thymocytes was reduced. A similar phenomenon was not observed in transgenic mice treated with unmodified OVA. As autoreactive T-cells are known to be clonally deleted at the immature double positive stage in the thymus. Th-cell tolerance induced by PEG--protein antigens is at least in part mediated by central tolerance in the thymus, and is likely caused by the markedly enhanced stability of PEG--protein conjugates in the circulatory system.
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Affiliation(s)
- T Saito
- Department of Biomedical Engineering, Toin University of Yokohama, Japan
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33
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Yamada H, Sakamoto R, Oda Y, Hiramatsu T, Kinoshita M, Ogino M, Matsuda R, Sudo S, Kato S, Fisher P, Baylor L, Gouge M. Development of pellet injector system for large helical device. Fusion Engineering and Design 2000. [DOI: 10.1016/s0920-3796(00)00342-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Matsumoto S, Suenaga H, Naito K, Sawazaki M, Hiramatsu T, Agata N. Management of suspected nosocomial infection: an audit of 19 hospitalized patients with septicemia caused by Bacillus species. Jpn J Infect Dis 2000; 53:196-202. [PMID: 11135704] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
From April to August of 2000, Bacillus spp. were detected in the blood culture of 29 patients in a hospital in Japan. Of these patients, 19 had clinical signs of septicemia; positive culture in the remaining 10 patients was attributed to contamination with skin flora at the site of puncture. Of the 18 strains evaluated, 15 were Bacillus cereus, 2 were Bacillus subtilis, and one was Bacillus licheniformis. The only hospital death observed was that of a patient who had no clinical signs of septicemia at the time of blood sampling. That death is now considered attributable to the underlying neoplasm. The hospital committee for prevention of nosocomial infection concluded after a critical review of the patient records that the cause of septicemia in most cases had been contaminated intravenous lines. To control the situation, the committee recommended the use of a new skin disinfectant, and medical personnel were advised to avoid infusion pauses with interruption of intravenous lines and to replace the caps for the stopcocks with new ones each time the caps were removed. These measures were rigorously observed in addition to the conventional measures for preventing catheter sepsis, and the incidence of septicemia due to the Bacillus spp. declined dramatically thereafter.
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Affiliation(s)
- S Matsumoto
- The Committee for Prevention of Nosocomial Infection, Komaki Municipal Hospital, Aichi 485-8820, Japan.
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35
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Kinuya S, Yokoyama K, Hiramatsu T, Konishi S, Watanabe N, Shuke N, Aburano T, Bunko H, Michigishi T, Tonami N. Optimal timing of administration of hyperthermia in combined radioimmunotherapy. Cancer Biother Radiopharm 2000; 15:373-9. [PMID: 11041022 DOI: 10.1089/cbr.2000.15.373] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [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: 11/12/2022] Open
Abstract
Local hyperthermia (HT) may enhance the efficacy of radioimmunotherapy (RIT). However, the optimal timing of HT relative to administration of antibody is unknown. Human colon cancer xenografts (290 +/- 26 mm3) were treated with 4.63 MBq 131I-A7 monoclonal antibody (MAb) anti-Mr 45,000 glycoprotein antigen on colorectal cancer, and HT at 43 degrees C for 1 h was administered at: (A), 2 days after the 131I-A7 injection at the maximum 131I-A7 tumor accumulation (radiation); (B), soon after the 131I-A7 injection aiming to increase the tumor accumulation of 131I-A7 due to HT vascular effects; or (C), 2 days before the 131I-A7 injection in an attempt at injecting 131I-A7 when increased antigen expression could be expected. Specific growth delay (SGD) of tumors was calculated as (Tqtreat-Tqcontrol)/Tqcontrol where Tq was tumor quadrupling time. The biodistribution and intratumoral distribution of 131I-A7 were investigated to explore the mechanism of tumor response among the different HT regimens. HT alone produced some antitumor effect (SGD 1.90 +/- 0.26), which was less effective than RIT (3.11 +/- 0.50). HT soon after 131I-A7 RIT (B) significantly enhanced RIT efficacy (6.57 +/- 0.51, p < 0.0001) whereas neither HT at 2 days after RIT (A) nor at 2 days before RIT (C) did so. Biodistribution study revealed that HT soon after RIT (B) increased the tumor radiation absorbed dose by a factor of 2.4, while HT after RIT (A) did not increase radiation dose and HT before RIT (C) decreased it. Radioluminograms of tumor sections indicated that HT soon after RIT (B) improved the uniformity of 131I-A7 distribution whereas HT after RIT (A) did not and HT before RIT (C) diminished the uniformity of A7 distribution. In conclusion, the best therapeutic efficacy was obtained when HT was combined soon after the initiation of RIT with 131I-A7. The increased tumor radiation absorbed dose and the uniform intratumoral distribution of 131I-A7 were important factors underlying this improvement, and the additive cytotoxicity of HT is suspected to some extent. HT-induced radiosensitization of tumor was not apparent in this model when HT was given 2 days after 131I-A7 MAb.
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Affiliation(s)
- S Kinuya
- Department of Nuclear Medicine, Kanazawa University School of Medicine, Japan.
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Kinuya S, Yokoyama K, Kawashima A, Hiramatsu T, Konishi S, Shuke N, Watanabe N, Takayama T, Michigishi T, Tonami N. Pharmacologic intervention with angiotensin II and kininase inhibitor enhanced efficacy of radioimmunotherapy in human colon cancer xenografts. J Nucl Med 2000; 41:1244-9. [PMID: 10914917] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023] Open
Abstract
UNLABELLED Induced hypertension and kininase inhibition can enhance tumor targeting of radiolabeled monoclonal antibody (MAb) by altering tumor circulation. This study investigated the effect of this manipulation on the antitumor efficacy of radioimmunotherapy (RIT). METHODS Mice bearing human colon cancer xenografts were administered 2.0 microg/kg/min of angiotensin II (AT-II) for 1 h and 30 microg of a kininase inhibitor, enalapril maleate, before the administration of 3.7 MBq (131)I-A7, an IgG1 against 45-kDa glycoprotein on colorectal cancer, and tumor growth was observed thereafter. The mechanism of the manipulation effect was investigated by estimation of the tissue absorbed dose and radioluminography of tumors. RESULTS The pharmacologic manipulation with AT-II and enalapril improved the tumor quadrupling time (Tq) of 3.7 MBq RIT from 24.3 +/- 2.75 d to 33.1 +/- 2.83 d (P < 0.05). Addition of this manipulation made 3.7 MBq RIT as effective as 9.25 MBq RIT alone (Tq, 37.2 +/- 2.97 d). Dose estimation showed that the manipulation increased the tumor absorbed dose 1.55-fold without affecting the doses to normal tissues. Uniform intratumoral distribution in the manipulated tumors was shown by radioluminography. CONCLUSION Larger and more uniform tumor radiation produced by this pharmacologic manipulation can benefit RIT with (131)I-MAb.
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Affiliation(s)
- S Kinuya
- Department of Nuclear Medicine, Kanazawa University School of Medicine, Japan
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Kanoh H, Izumi T, Hiramatsu T, Ohnishi M, Murai M, Seishima M. Granulomatous nodule on vocal cord possibly induced by etretinate therapy. Br J Dermatol 2000; 142:1258-60. [PMID: 10848772 DOI: 10.1046/j.1365-2133.2000.03575.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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38
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Takagi T, Hashiguchi M, Hiramatsu T, Yamashita F, Takakura Y, Hashida M. Effect of cationic liposomes on intracellular trafficking and efficacy of antisense oligonucleotides in mouse peritoneal macrophages. J Drug Target 2000; 7:363-71. [PMID: 10721798 DOI: 10.3109/10611869909085519] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [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: 11/13/2022]
Abstract
We have investigated the intracellular fate and antisense effect of oligonucleotide/cationic liposome complexes using phosphorothioate oligonucleotides (S-Oligo) targeted to inducible nitric oxide synthase in mouse peritoneal macrophages. Confocal laser microscopic analysis revealed that, after application of fluorescein isothiocyanate (FITC)-labeled S-Oligo alone, the intracellular localization of fluorescence exhibited a punctate pattern in the cytoplasm, suggesting that the oligonucleotides were mainly confined to the endosomal and/or lysosomal compartments. In the case of complexation with Lipofectin and DMRIE-C liposomes, cellular uptake of FITC-S-Oligo was not greatly enhanced and the fluorescence localization in the cells was similar to that of FITC-S-Oligo alone. LipofectAMINE slightly enhanced cellular uptake of FITC-S-Oligo; however, the intracellular localization profile of FITC-S-Oligo remained largely unchanged. The antisense effect was slightly enhanced by LipofectAMINE under only very limited experimental conditions. It was concluded that cationic liposomes are not a potential carrier for S-Oligo in peritoneal macrophages because of their inability to promote the release of S-Oligo from the endosomal compartments to the cytosol over a non-toxic concentration range.
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Affiliation(s)
- T Takagi
- Department of Drug Delivery Research, Graduate School of Pharmaceutical Sciences, Kyoto University, Japan
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Kinuya S, Yokoyama K, Konishi S, Hiramatsu T, Watanabe N, Shuke N, Aburano T, Takayama T, Michigishi T, Tonami N. Enhanced efficacy of radioimmunotherapy combined with systemic chemotherapy and local hyperthermia in xenograft model. Jpn J Cancer Res 2000; 91:573-8. [PMID: 10835504 PMCID: PMC5926375 DOI: 10.1111/j.1349-7006.2000.tb00983.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
We previously found that the efficacy of radioimmunotherapy (RIT) with (131)I-A7, an IgG(1) against M(r) 45000 glycoprotein on colon cancer, was enhanced by local hyperthermia (HT) or chemotherapy with 5-fluorouracil (5-FU). In this study, we aimed to further enhance its efficacy by combining these three modalities. Human colon cancer xenografts (146 x 12 mm(3)) in Balb / c nu / nu female mice were treated with 9.25 MBq (131)I-A7 i.v. combined with HT (43 degrees C for 1 h) and 5-FU (30 mg / kg / day i.p. for 5 days). Tumor growth delay, (Tq(treated) - Tq(control) )/ Tq(control) where Tq is tumor quadrupling time, in mice treated with RIT + HT + 5-FU was improved to 12.7 from 5.90, 7.55 and 10.1 with RIT alone, RIT + 5-FU and RIT + HT, respectively. Complete response was observed in 4 out of 8 tumors with RIT + HT + 5-FU and 3 out of 10 with RIT + HT. No tumor showed complete response with RIT + 5-FU or RIT alone. 5-FU slightly increased myelotoxicity of RIT, but HT did not affect it. Body weight loss was not enhanced by the combination. These results indicate that the combination of three modalities is a feasible approach to enhance the antitumor efficacy of RIT without serious increase of toxicity.
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Affiliation(s)
- S Kinuya
- Department of Nuclear Medicine, Kanazawa University School of Medicine, 13-1 Takaramachi, Kanazawa 920-8640, Japan. kinuya@med. kanazawa-u.ac.jp
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40
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Abstract
A 7-year-old boy underwent ventricular and atrial septal defect patch closures, pulmonary valvulotomy, left pulmonary artery dilatation, and bicaval Glenn shunt, which maintained good patency between the superior vena cava and right atrium, because of a reduced right ventricular end-diastolic volume (RVEDV). The RVEDV had increased at 15 years of age; therefore, we performed an anatomic biventricular correction by removing the bicaval Glenn shunt. We found that anatomic biventricular correction becomes possible if RVEDV increases postoperatively.
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Affiliation(s)
- H Tsukui
- Department of Pediatric Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical University
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Shin'oka T, Imai Y, Takanashi Y, Seo K, Terada M, Aoki M, Hiramatsu T, Ohta J, Kashiwagi J, Morishima S, Konuma T. [Pulmonary outflow tract reconstruction with autologous tissue during the Ross procedure: right ventricular characteristics in mid-term follow-up]. Kyobu Geka 2000; 53:175-81; discussion 181-4. [PMID: 10714103] [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: 02/15/2023]
Abstract
BACKGROUND The Ross procedure requires the interposition of prosthetic or homograft extracardiac conduits to establish ventricle-pulmonary artery connection (RV-PA). These materials usually require multiple reoperations because of conduit failure. To avoid the re-replacement of currently available conduits, usage of autologous tissue may be preferable to reconstruct RV-PA connection during the Ross procedure, especially in the pediatric age group. METHOD Ten patients (mean age 8.7 years, range 2-23) with congenital aortic valve disease underwent the Ross procedure between June, 1996 and July, 1998. To establish RV-PA continuity, autologous aortic wall including aortic valve with a gusset of pericardial tissue was used in six patients, rolled pericardial conduit with fresh pericardial bicuspid valve in three and one direct anastomosis of pulmonary posterior wall onto the right ventricle with a fresh pericardial monocusp valved patch. All patient's postoperative courses were uneventful. All patients were followed up (mean follow-up period: 21.6 +/- 6.6 months) and postoperative right ventricular characteristics, cardio-thoracic ratio (CTR) on chest X-ray and pulmonary valve function were evaluated. RESULTS Postoperative right ventricular end-diastolic volume, right ventricular ejection fraction and right ventricular end-diastolic pressure did not change significantly (RVEDV: 128 to 113% of normal, RVEF: 56.4 to 51.5%, RVEDP: 5.9 to 10.1 mmHg). Pulmonary regurgitation during follow-up was mild in six patients and moderate in four. However, CTR decreased significantly over time (preop.: 56.5% postop.: 58.5%, late period: 53.4%). CONCLUSION Our results support the concept of the reconstruction of pulmonary outflow tract without foreign materials during the Ross procedure. Longer follow-up are necessary to define the possible limitation of this technique.
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Affiliation(s)
- T Shin'oka
- Department of Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical University, Japan
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Kinuya S, Yokoyama K, Tega H, Hiramatsu T, Konishi S, Watanabe N, Shuke N, Aburano T, Takayama T, Michigishi T, Tonami N. Efficacy, toxicity and mode of interaction of combination radioimmunotherapy with 5-fluorouracil in colon cancer xenografts. J Cancer Res Clin Oncol 1999; 125:630-6. [PMID: 10541970 DOI: 10.1007/s004320050326] [Citation(s) in RCA: 13] [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] [Indexed: 11/26/2022]
Abstract
PURPOSE The feasibility of radioimmunotherapy (RAIT) combined with 5-fluorouracil (5-FU) was examined in colon cancer xenografts. The mode of interaction of the two treatments was also investigated. METHODS Mice bearing human colon cancer were treated with a combination of 4.63 MBq (L-RAIT) or 9.25 MBq (H-RAIT) (131)I-A7, an IgG1 against 45-kDa glycoprotein, and 5-FU at a dose of 30 mg kg(-1)day(-1) for 5 days. Myelotoxicity was monitored by blood cell counts and intestinal toxicity was assessed by the dosimetry. The results were compared with those of a single-modality therapy. RESULTS The combination of 5-FU with H-RAIT enhanced the antitumor effect, improving the tumor quadrupling time from 25.3 +/- 9.59 days to 31.3 +/- 8.32 days (P < 0.05) and inducing tumor regression in 7 out of 10 mice, compared to 3 out of 9 mice treated with H-RAIT alone. The efficacy of L-RAIT was also improved by the combination. Analysis of the dose/response relationship showed an additive interaction of the two modalities. The combination of 5-FU with RAIT induced slightly more severe myelotoxicity than a single-modality treatment, but blood cell counts recovered similarly. Dose estimation suggested that RAIT does not increase the intestinal toxicity of 5-FU. CONCLUSION The combination of two modalities would be feasible for the treatment of colon cancer, increasing antitumor effect with minor effect on toxicity.
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Affiliation(s)
- S Kinuya
- Department of Nuclear Medicine, Kanazawa University School of Medicine, 13-1 Takaramachi, Kanazawa, Ishikawa 920-8640, Japan.
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Abstract
BACKGROUND Mitral valve repair in the pediatric population remains demanding because of a diversity of apparatus anomalies and the young age of the patients. METHODS We reviewed our clinical results for mitral valve repairs for congenital mitral insufficiency. Forty-nine consecutive patients aged 2 months to 34 years (mean, 4.4 years) had mitral valve repair between June 1984 and December 1996. Forty-one patients (83.7%) had associated cardiac anomalies. The predominant pathologies for the regurgitations were chordal anomalies in 34 patients (69%), annular dilatation in 8 (16%), and leaflet anomalies in 7 (14%). Mitral valve repair included commissure plication annuloplasty in 43 patients (88%), modified DeVega in 11, cleft closure in 5, plication of the anterior leaflet in 3, triangular resection of the anterior leaflet in 2, chordal shortening in 1, and placement of artificial chordae in 1. Several combined techniques were required in 19 patients. RESULTS There were no early or late deaths. The follow-up period was from 6 to 166 months (mean, 88.4 months). Forty-seven patients (95.9%) were in New York Heart Association class I. The long-term echocardiographic studies showed that 2 of 30 patients without reoperation had moderate regurgitation. The actuarial freedom from reoperation was 85.6% (95% confidence limits, 72.8%, 98.4%) at 13 years. Five patients (10.2%) required valve replacement from 13 days to 75 months after the valve repair. Two patients had cerebral ischemic events as a result of cardiomegaly and atrial fibrillation. CONCLUSIONS Valve repair for congenital mitral insufficiency gave adequate results in combination with commissure plication annuloplasty and other techniques with excellent long-term functional status.
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Affiliation(s)
- H Ohno
- Department of Pediatric Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical University.
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Abstract
BACKGROUND The endothelium-derived vasoconstrictor endothelin (ET)-1 might contribute to the physiology of blood flow regulation and play a role in cardiovascular disease. Adrenomedullin (AM) is a potent vasodilator peptide that has major effects on cardiovascular function and has multiple biologic effects involved in cardiovascular homeostasis. Although pulmonary vascular resistance is known to be one of the most important factors to determine the indications for a Fontan procedure, the time course of the plasma cytokine before and after the Fontan procedure is not known. METHODS Sixteen patients were divided into two groups, 8 patients (1 to 14 years) who had the Fontan procedure (atriopulmonary connection) and 8 age-matched controls who had biventricular repair with normal central venous pressure. Plasma ET-1 and adrenomedullin levels were measured in both groups immediately before cardiopulmonary bypass, immediately after cardiopulmonary bypass, and 6 and 24 hours after cardiopulmonary bypass. A thermodilution catheter was inserted during the operation, and mean pulmonary arterial pressure, pulmonary wedge pressure, and cardiac output were measured, and pulmonary vascular resistance was calculated at the same time points. Correlation between the plasma ET-1 levels and pulmonary vascular resistance data were obtained in the Fontan group. RESULTS Plasma ET-1 levels in the Fontan group were elevated after operation and were higher than the control group at 6 and 24 hours after cardiopulmonary bypass. Plasma adrenomedullin in the Fontan group was lower than in the control group at 6 and 24 hours after cardiopulmonary bypass. A significant positive correlation was obtained between the plasma ET-1 and pulmonary vascular resistance data (r = 0.475). CONCLUSIONS Imbalance between increased ET-1 and relatively decreased adrenomedullin after cardiopulmonary bypass in the Fontan procedure could contribute to dominant effects of ET-1, which might induce vasoconstriction after the Fontan procedure. ET-1 might play an important role in maintaining vasoconstriction after the Fontan procedure.
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Affiliation(s)
- T Hiramatsu
- Department of Pediatric Cardiac Surgery, Tokyo Women's Medical University, Heart Institute of Japan
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Kinuya S, Yokoyama K, Yamamoto W, Kawashima A, Konishi S, Hiramatsu T, Tega H, Shuke N, Aburano T, Watanabe N, Takayama T, Michigishi T, Tonami N. Persistent distension and enhanced diffusive extravasation of tumor vessels improved uniform tumor targeting of radioimmunoconjugate in mice administered with angiotensin II and kininase inhibitor. Oncol Res 1999; 10:551-9. [PMID: 10367936] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
Induced hypertension with angiotensin II (AT-II) and the inhibition of kininase with enalapril maleate may increase the tumor targeting of radiolabeled monoclonal antibodies (MAbs). We previously found that short-period infusion of 2.0 microg/kg/min of AT-II enhanced tumor targeting of MAb without an impact on normal tissue distribution. In this study, we aimed to optimize the manipulation with these agents, and examine the possible mechanism of their effects on MAb distribution. Effect of the manipulation on tissue circulation was assessed in mice bearing colon cancer xenografts by 201Tl and 99mTc-human serum albumin (HSA) as markers of tissue blood flow and tissue blood volume and/or vascular permeability. A dose finding study of enalapril ranging from 3 to 300 microg showed that 30 microg of enalapril in combination with AT-II infusion produced the best improvement in tumor uptake of 99Tc-HSA without altering 201Tl distribution, suggesting that the increase of vascular permeability was caused by enalapril. AT-II infusion for longer than 1 h affected renal blood flow and caused subcutaneous edema. Tumor uptake of (111)In-A7, a murine IgG1, was 1.62-fold improved 72 h postinjection (P < 0.001) and intratumoral distribution became uniform with 2.0 microg/kg/min of AT-II for 1 h and 30 microg of enalapril. Vessels in manipulated tumors were distended even 48 h after the cessation of AT-II infusion. In conclusion, it was suggested that persistent distension of tumor vessels and the increase of diffusive extravasation of MAb caused by short-period-induced hypertension and inhibition of bradykinin degradation produced favorable effect for the MAb distribution in tumors.
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Affiliation(s)
- S Kinuya
- Department of Nuclear Medicine, Kanazawa University School of Medicine, Japan.
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Kinuya S, Yokoyama K, Hiramatsu T, Tega H, Tanaka K, Konishi S, Shuke N, Aburano T, Watanabe N, Takayama T, Michigishi T, Tonami N. Combination radioimmunotherapy with local hyperthermia: increased delivery of radioimmunoconjugate by vascular effect and its retention by increased antigen expression in colon cancer xenografts. Cancer Lett 1999; 140:209-18. [PMID: 10403561 DOI: 10.1016/s0304-3835(99)00090-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Hyperthermia (HT) may increase tumor targeting of a radiolabeled antibody by its effects on tumor vasculature and antigen expression. Expression of a 45-kDa glycoprotein antigen on LS180 colon cancer cells was 2.7-fold enhanced 2 days after heating at 43 degrees C for 1 h. Preferential tumor accumulation of 125I-A7 recognizing this antigen was doubled and the antitumor effect of 131I-A7 was significantly improved by HT. Hyperthermia also increased tumor uptake of an irrelevant antibody but its radioactivity was rapidly cleared. These results indicate that HT increased the initial delivery of an antibody to a tumor by its vascular effect, and radioactivity was retained in tumors by increased specific binding, resulting in a better radioimmunotherapy outcome.
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MESH Headings
- Animals
- Antibodies, Monoclonal/pharmacokinetics
- Antibodies, Monoclonal/therapeutic use
- Antigens, Neoplasm/biosynthesis
- Antigens, Neoplasm/immunology
- Chromatography, High Pressure Liquid
- Colonic Neoplasms/blood supply
- Colonic Neoplasms/therapy
- Combined Modality Therapy
- Female
- Humans
- Hyperthermia, Induced
- Immunoconjugates/pharmacokinetics
- Immunoconjugates/therapeutic use
- Iodine Radioisotopes
- Mice
- Mice, Inbred BALB C
- Mice, Nude
- Neoplasm Transplantation
- Radioimmunotherapy
- Time Factors
- Tissue Distribution
- Transplantation, Heterologous
- Tumor Cells, Cultured
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Affiliation(s)
- S Kinuya
- Department of Nuclear Medicine, Kanazawa University School of Medicine, Japan.
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Kinuya S, Yokoyama K, Watanabe N, Hiramatsu T, Tega H, Konishi S, Shuke N, Aburano T, Takayama T, Michigishi T, Tonami N. Early response of tumour to radiotherapy should be assessed by both uptake and retention of single photon tracers: in vitro analysis with 201Tl-chloride, 99Tcm-sestamibi and 99Tcm-tetrofosmin in human bladder cancer cells and human leukocytes. Nucl Med Commun 1999; 20:581-8. [PMID: 10451872 DOI: 10.1097/00006231-199906000-00014] [Citation(s) in RCA: 5] [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: 11/25/2022]
Abstract
The uptake and retention of single photon tracers in irradiated tumour cells was observed in an attempt at the early evaluation of the effect of radiation. T24 human bladder cancer cells were exposed to a single dose of 10 Gy or 20 Gy or a fractionated dose of 10 Gy (2 Gy for 5 days). The uptake of 201Tl chloride, 99Tcm-sestamibi and 99Tcm-tetrofosmin was observed by incubating in vitro for 60 min. The retention of the tracers was observed at 60 min after changing the incubation medium for a tracer-free medium. Uptake per culture well of all tracers in the cells exposed to 20 Gy declined as viable cell number decreased, but uptake per cell increased progressively. Uptake per cell of all tracers in the cells exposed to either a single dose or a fractionated dose of 10 Gy also increased, while a delay in growth was observed. The retention of these tracers decreased during this period and recovered thereafter. A binding assay with purified human leukocytes indicated that assessment with 99Tcm-sestamibi and 99Tcm-tetrofosmin is influenced by inflammatory cells. In conclusion, the effect of radiation may be underestimated if assessed by tracer uptake alone because of the increase in tracer uptake in viable irradiated cells. Observation of the retention of tracers may provide additional information.
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Affiliation(s)
- S Kinuya
- Department of Nuclear Medicine, Kanazawa University School of Medicine, Japan.
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Ohkado A, Imai Y, Takanashi Y, Seo K, Terada M, Aoki M, Hiramatsu T, Ohta J, Hagino I. [A case of Bentall's operation for an 11-year-old patient with Marfan syndrome]. Kyobu Geka 1999; 52:201-3. [PMID: 10097546] [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: 02/11/2023]
Abstract
An 11-year-old girl who was diagnosed to have Marfan syndrome in her infancy, visited us with complaints of easy fatigability and chest discomfort. She was pointed out to have acute development of annuloaortic ectasia with severe aortic regurgitation and mild mitral regurgitation. She underwent replacement of the ascending aorta and aortic valve using composite graft with prosthetic valve (Bentall's operation) and circular annuloplasty of the mitral valve. Bentall's operation for infants and children is remarkably rare because in this generation, acute development of aortic dilatation leading rupture and dissection is quite infrequent while main death is caused by mitral regurgitation.
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Affiliation(s)
- A Ohkado
- Department of Pediatric Cardiovascular Surgery, Heart Institute of Japan, Tokyo Women's Medical College, Japan
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Abstract
We cloned several genes encoding an Na+/H+ antiporter of Staphylococcus aureus from chromosomal DNA by using an Escherichia coli mutant, lacking all of the major Na+/H+ antiporters, as the host. E. coli cells harboring plasmids for the cloned genes were able to grow in medium containing 0.2 M NaCl (or 10 mM LiCl). Host cells without the plasmids were unable to grow under the same conditions. Na+/H+ antiport activity was detected in membrane vesicles prepared from transformants. We determined the nucleotide sequence of the cloned 7-kbp region. We found that seven open reading frames (ORFs) were necessary for antiporter function. A promoter-like sequence was found in the upstream region from the first ORF. One inverted repeat followed by a T-cluster, which may function as a terminator, was found in the downstream region from the seventh ORF. Neither terminator-like nor promoter-like sequences were found between the ORFs. Thus, it seems that the seven ORFs comprise an operon and that the Na+/H+ antiporter consists of seven kinds of subunits, suggesting that this is a novel type of multisubunit Na+/H+ antiporter. Hydropathy analysis of the deduced amino acid sequences of the seven ORFs suggested that all of the proteins are hydrophobic. As a result of a homology search, we found that components of the respiratory chain showed sequence similarity with putative subunits of the Na+/H+ antiporter. We observed a large Na+ extrusion activity, driven by respiration in E. coli cells harboring the plasmid carrying the genes. The Na+ extrusion was sensitive to an H+ conductor, supporting the idea that the system is not a respiratory Na+ pump but an Na+/H+ antiporter. Introduction of the plasmid into E. coli mutant cells, which were unable to grow under alkaline conditions, enabled the cells to grow under such conditions.
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Affiliation(s)
- T Hiramatsu
- Department of Microbiology, Faculty of Pharmaceutical Sciences, Okayama University, Tsushima, Okayama 700-8530, Japan
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Tanaka SA, Hiramatsu T, Oshitomi T, Imai Y, Koyanagi H. Induction of donor-specific tolerance to cardiac xenografts in utero. J Heart Lung Transplant 1998; 17:888-91. [PMID: 9773861] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND Problems associated with heart transplantation, such as shortage of suitable organs and the side effects of immunosuppressive therapy, are especially serious for patients in the pediatric age group. Induction of donor-specific immunologic tolerance without immunosuppressive drugs would be ideal for clinical organ transplantation. In this study, we used a vascularized cardiac xenograft model to achieve donor-specific unresponsiveness without immunosuppression by manipulating the intrauterine immune response. METHODS Lewis rats and Golden Syrian hamsters were used as the recipients and donors, respectively. Donor bone marrow cells (15 x 10(6) in 0.05 mL) were injected into each fetus of pregnant Lewis rats on days 9 (n = 2) and 16 (n = 2) of gestation. Donor hearts were heterotopically transplanted into each surviving (n = 8, n = 5) fetus of the Lewis rats at 8 weeks of age. Donor hearts were also transplanted into untreated rats as controls (n = 8). RESULTS The mean cardiac xenograft survival time was 2.5 +/- 0.5, 7.4 +/- 4.1, and 2.8 +/- 0.8 days in the control group, gestational day 9 group, and gestational day 16 group, respectively. Chromosomal analysis of the day 9 group showed Golden Syrian hamster chromosomes as well as Lewis rat chromosomes. CONCLUSIONS Cardiac xenograft survival was significantly prolonged by intrauterine exposure to xenograft bone marrow cells on day 9 but not on day 16 of gestation. Cardiac xenograft survival and chromosomal analysis of the recipient bone marrow suggested that chimerism was achieved between Golden Syrian hamsters and Lewis rats. Cardiac xenotransplantation may be possible by induction of donor-specific tolerance in utero.
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Affiliation(s)
- S A Tanaka
- Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women's Medical College
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