1
|
Kohada Y, Goto K, Tasaka R, Nishida K, Hashimoto K, Iwamoto H, Hatayama T, Furutani T, Miyamoto S, Kobatake K, Kitano H, Ikeda K, Goriki A, Hieda K, Hayashi T, Hinata N. Prognostic Impact of the Modified 5-Item Frailty Index After Radical Nephroureterectomy in Patients With Upper Tract Urothelial Carcinoma: A Multicenter Retrospective Study. Clin Genitourin Cancer 2024; 22:322-329.e3. [PMID: 38104030 DOI: 10.1016/j.clgc.2023.11.015] [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: 10/03/2023] [Revised: 11/16/2023] [Accepted: 11/23/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION The modified 5-item frailty index can be used to evaluate frailty using 5 routinely encountered clinical variables. This study aimed to assess the impact of the modified 5-item frailty index in patients who underwent radical nephroureterectomy for upper tract urothelial carcinoma. PATIENTS AND METHODS In this multicenter retrospective study, we calculated the modified 5-item frailty index scores of patients who underwent radical nephroureterectomy for upper tract urothelial carcinoma between 2010 and 2022. Patients were categorized into the high (≥2) and low (≤1) modified 5-item frailty index score groups. To assess the prognostic influence of the preoperative modified 5-item frailty index, we conducted Cox proportional regression analyses concerning progression-free, overall, and cancer-specific survival. RESULTS Of 434 patients, 82, and 352 were classified into the high and low modified 5-item frailty index score groups, respectively. The high modified 5-item frailty index score group had significantly higher rates of severe surgical complications (P = .038) and ≥30 days of hospitalization (P = .049) and significantly worse progression-free (P = .012) and overall survival (P = .002) than the low modified 5-item frailty index score group. The multivariable Cox proportional hazard analysis revealed that a high modified 5-item frailty index score was independently associated with poor progression-free (P = .044), overall (P = .017), and cancer-specific survival (P = .005). CONCLUSION The modified 5-item frailty index emerged as a significant predictive indicator of severe surgical complications and postoperative survival outcomes in patients with upper tract urothelial carcinoma treated with radical nephroureterectomy.
Collapse
Affiliation(s)
- Yuki Kohada
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Keisuke Goto
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan.
| | - Ryo Tasaka
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Kensuke Nishida
- Department of Urology, Higashihiroshima Medical Center, Hiroshima, Japan
| | | | - Hideo Iwamoto
- Department of Urology, JA Onomichi General Hospital, Hiroshima, Japan
| | - Tomoya Hatayama
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan; Department of Urology, Asa Citizens Hospital, Hiroshima, Japan
| | - Tomoki Furutani
- Department of Urology, Kure Medical Center Chugoku Cancer Center, Hiroshima, Japan
| | - Shunsuke Miyamoto
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Kohei Kobatake
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Hiroyuki Kitano
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Kenichiro Ikeda
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Akihiro Goriki
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan; Department of Urology, Asa Citizens Hospital, Hiroshima, Japan
| | - Keisuke Hieda
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Tetsutaro Hayashi
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| | - Nobuyuki Hinata
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan
| |
Collapse
|
2
|
Hatayama T, Goto K, Fujiyama K, Goriki A, Kaneko M, Mita K. Risk classification system using the detailed positive surgical margin status for predicting biochemical recurrence after robot-assisted radical prostatectomy. Asia Pac J Clin Oncol 2024. [PMID: 38512888 DOI: 10.1111/ajco.14053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 09/01/2023] [Accepted: 02/25/2024] [Indexed: 03/23/2024]
Abstract
AIM This study aimed to evaluate the risk classification system using the detailed positive surgical margin (PSM) status to predict biochemical recurrence (BCR) after robot-assisted radical prostatectomy (RARP). METHODS We retrospectively analyzed 427 patients who underwent RARP between January 2016 and March 2020. We investigated risk factors for BCR using univariate and multivariate Cox proportional hazard regression models. The biochemical recurrence-free survival (BRFS) rate was assessed using the Kaplan-Meier method. RESULTS The median follow-up period was 43.4 months and 99 patients developed BCR. In the multivariate analysis, maximum PSM length > 5.0 mm and the International Society of Urological Pathology grade group (ISUP GG) at the PSM ≥3 were predictive factors for BCR in patients with a PSM. In the multivariate analysis, these factors were also independent predictive factors in the overall study population, including patients without a PSM. We classified the patients into four groups using these factors and found that the 1-year BRFS rates in the negative surgical margin (NSM) group, low-risk group (PSM and neither factor), intermediate-risk group (either factor), and high-risk group (both factors) were 94.9%, 94.5%, 83.1%, and 52.9%, respectively. The low-risk group showed similar BRFS to the NSM group (p = 0.985), while the high-risk group had significantly worse BRFS than the other groups (p < 0.001). CONCLUSION Maximum PSM length > 5.0 mm and ISUP GG at the PSM ≥3 were independent predictive factors for BCR after RARP. Risk classification for BCR using these factors is considered to be useful and might help urologists decide on additional treatment after RARP.
Collapse
Affiliation(s)
- Tomoya Hatayama
- Department of Urology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
| | - Keisuke Goto
- Department of Urology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kenta Fujiyama
- Department of Urology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
| | - Akihiro Goriki
- Department of Urology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
| | - Mayumi Kaneko
- Department of Diagnostic Pathology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
| | - Koji Mita
- Department of Urology, Hiroshima City North Medical Center Asa Citizens Hospital, Hiroshima, Japan
| |
Collapse
|
3
|
Fukushima T, Goto K, Hayashi T, Ikeda K, Hatayama T, Yamanaka R, Iwane K, Tasaka R, Kohada Y, Takemoto K, Kobatake K, Goriki A, Toshida A, Nakahara H, Motonaga M, Tokumo K, Fujii Y, Hayes CN, Okamoto W, Kubo T, Matsumoto T, Shiota M, Yamamoto N, Urabe Y, Hiyama E, Arihiro K, Hinoi T, Hinata N. Comprehensive genomic profiling testing in Japanese castration-resistant prostate cancer patients: results of a single-center retrospective cohort study. Jpn J Clin Oncol 2024; 54:175-181. [PMID: 37899139 DOI: 10.1093/jjco/hyad148] [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: 08/04/2023] [Accepted: 10/06/2023] [Indexed: 10/31/2023] Open
Abstract
OBJECTIVE Comprehensive genomic profiling testing using a hybrid-capture next-generation sequencing is commonly used in clinical practice to employ precision medicine in cancer treatment worldwide. In this study, we aimed to analyze the profiles obtained using comprehensive genomic profiling testing that was performed in Japanese castration-resistant prostate cancer patients and to discuss the genetic findings in a real-world setting. METHODS A total of 60 cases and 57 castration-resistant prostate cancer patients underwent comprehensive genomic profiling testing between 1 January 2021 and 31 December 2022. Four types of comprehensive genomic profiling testing were selected, and clinically significant cancer-specific gene alterations were identified. RESULTS The median age of patients was 74 years, and the median prostate-specific antigen value at the time of submission was 18.6 ng/ml. Fifty-seven (95%) of 60 cases were metastatic castration-resistant prostate cancers, and 3 cases (5%) were non-metastatic. Among all genetic alterations, androgen-receptor alteration was the most frequently detected in 17 cases (28.3%), followed by 15 cases of TP53 (25.0%), 14 cases of CDK12 (23.3%), 10 cases of phosphatase and tensin homolog (16.7%) and 9 cases of ATM (15.0%) mutations. A total of 13 patients (21.7%) received systemic therapy according to the comprehensive genomic profiling testing results. Overall, the survival rate was significantly greater in the group treated through systemic therapy based on comprehensive genomic profiling testing compared with the group without new therapeutic treatment (P = 0.041). CONCLUSIONS Comprehensive genomic profiling testing is recommended in castration-resistant prostate cancer patients identified as resistant to standard therapy as this can provide a new therapeutic option.
Collapse
Affiliation(s)
- Takafumi Fukushima
- Department of Urology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Keisuke Goto
- Department of Urology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tetsutaro Hayashi
- Department of Urology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kenichiro Ikeda
- Department of Urology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Tomoya Hatayama
- Department of Urology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryoken Yamanaka
- Department of Urology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kyosuke Iwane
- Department of Urology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Ryo Tasaka
- Department of Urology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Yuki Kohada
- Department of Urology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kenshiro Takemoto
- Department of Urology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Kohei Kobatake
- Department of Urology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Akihiro Goriki
- Department of Urology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Asuka Toshida
- Department of Clinical and Molecular Genetics, Genomic Medicine Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Hikaru Nakahara
- Department of Clinical and Molecular Genetics, Genomic Medicine Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Masanori Motonaga
- Department of Pharmaceutical Services, Hiroshima University Hospital, Hiroshima, Japan
| | - Kentaro Tokumo
- Department of Clinical Oncology, Hiroshima University Hospital, Hiroshima, Japan
| | - Yasutoshi Fujii
- Department of Clinical Oncology, Hiroshima University Hospital, Hiroshima, Japan
- Department of Gastroenterology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - C Nelson Hayes
- Department of Gastroenterology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Wataru Okamoto
- Cancer Treatment Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Toshio Kubo
- Center for Clinical Oncology, Okayama University Hospital, Okayama, Japan
| | - Takashi Matsumoto
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masaki Shiota
- Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Noboru Yamamoto
- Department of Experimental Therapeutics, National Cancer Center Hospital, Tokyo, Japan
| | - Yuji Urabe
- Department of Gastrointestinal Endoscopy and Medicine, Hiroshima University Hospital, Hiroshima, Japan
| | - Eiso Hiyama
- Department of Pediatric Surgery, Hiroshima University Hospital, Hiroshima, Japan
- Natural Science Center for Basic Research and Development, Hiroshima University, Hiroshima, Japan
| | - Koji Arihiro
- Department of Anatomical Pathology, Hiroshima University Hospital, Hiroshima, Japan
| | - Takao Hinoi
- Department of Clinical and Molecular Genetics, Genomic Medicine Center, Hiroshima University Hospital, Hiroshima, Japan
| | - Nobuyuki Hinata
- Department of Urology, Graduate School of Biomedical & Health Sciences, Hiroshima University, Hiroshima, Japan
| |
Collapse
|
4
|
Mita K, Izumi K, Goriki A, Tasaka R, Hatayama T, Shima T, Kato Y, Kamiyama M, Inoue S, Tanaka N, Hoshi S, Okamura T, Yoshio Y, Enokida H, Chikazawa I, Kawai N, Hashimoto K, Fukagai T, Shigehara K, Takahara S, Kadono Y, Mizokami A. Enzalutamide versus Abiraterone Plus Prednisolone for Nonmetastatic Castration-Resistant Prostate Cancer: A Sub-Analysis from the ENABLE Study for PCa. Cancers (Basel) 2024; 16:508. [PMID: 38339260 PMCID: PMC10854983 DOI: 10.3390/cancers16030508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/07/2024] [Accepted: 01/20/2024] [Indexed: 02/12/2024] Open
Abstract
Enzalutamide (ENZ) and abiraterone plus prednisolone (ABI) can improve the survival of patients with castration-resistant prostate cancer (CRPC). However, the agent that is more effective against nonmetastatic CRPC remains unclear. To evaluate the agent that can be used as the first-line treatment for CRPC, an investigator-initiated, multicenter, randomized controlled trial (ENABLE Study for PCa) including both metastatic and nonmetastatic CRPC was conducted in Japan. The prostate-specific antigen (PSA) response rate, overall survival, some essential survival endpoints, and safety of patients with nonmetastatic CRPC were also analyzed. In this subanalysis, 15 and 26 patients in the ENZ and ABI arms, respectively, presented with nonmetastatic CRPC. There was no significant difference in terms of the PSA response rate between the ENZ and ABI arms (80% and 64%, respectively; p = 0.3048). The overall survival did not significantly differ between the two arms (HR: 0.68; 95% CI: 0.22-2.14, p = 0.5260). No significant differences were observed in terms of radiographic progression-free survival and cancer-specific survival between the ENZ and ABI arms (HR: 0.81; 95% CI: 0.35-1.84; p = 0.6056 and HR: 0.72; 95% CI: 0.19-2.73; p = 0.6443, respectively). Only four and six patients in the ENZ and ABI arms, respectively, had ≥grade 3 adverse events. ABI and ENZ had similar efficacy and safety profiles in patients with nonmetastatic CRPC.
Collapse
Affiliation(s)
- Koji Mita
- Department of Urology, Hiroshima City North Medical Center Asa Citizens Hospital, 1-2-1 Kameyama-Minami, Asakita-ku, Hiroshima 731-0293, Japan
| | - Kouji Izumi
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Akihiro Goriki
- Department of Urology, Hiroshima City North Medical Center Asa Citizens Hospital, 1-2-1 Kameyama-Minami, Asakita-ku, Hiroshima 731-0293, Japan
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Ryo Tasaka
- Department of Urology, Hiroshima City North Medical Center Asa Citizens Hospital, 1-2-1 Kameyama-Minami, Asakita-ku, Hiroshima 731-0293, Japan
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Tomoya Hatayama
- Department of Urology, Hiroshima City North Medical Center Asa Citizens Hospital, 1-2-1 Kameyama-Minami, Asakita-ku, Hiroshima 731-0293, Japan
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
| | - Takashi Shima
- Department of Urology, Toyama Prefectural Central Hospital, 2-2-78 Nishinagae, Toyama 930-8550, Japan
| | - Yuki Kato
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
- Department of Urology, Fukui-Ken Saiseikai Hospital, 7-1 Wadanakacho-Funabashi, Fukui 918-8503, Japan
| | - Manabu Kamiyama
- Department of Urology, University of Yamanashi, 1110 Shimokato, Chuo 409-3898, Japan
| | - Shogo Inoue
- Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, 1-2-3 Kasumi, Minami-ku, Hiroshima 734-8551, Japan
- Department of Urology, Shobara Red Cross Hospital, 2-7-10 Nishihonmachi, Shobara 727-0013, Japan
| | - Nobumichi Tanaka
- Department of Urology, Nara Medical University, 840 Shijocho, Kashihara 634-8521, Japan
| | - Seiji Hoshi
- Department of Urology, Fukushima Medical University, 1 Hikarigaoka, Fukushima 960-1295, Japan
| | - Takehiko Okamura
- Department of Urology, Anjo Kosei Hospital, 28 Anjocho-Higashihirokute, Anjo 446-8602, Japan
| | - Yuko Yoshio
- Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu 514-8507, Japan
| | - Hideki Enokida
- Department of Urology, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
| | - Ippei Chikazawa
- Department of Urology, Kanazawa Medical University, 1-1 Uchinadamachi-Daigaku, Kahoku 920-0293, Japan
| | - Noriyasu Kawai
- Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8602, Japan
| | - Kohei Hashimoto
- Department of Urology, School of Medicine, Sapporo Medical University, 16-291 Minami-1-Jo-Nishi, Sapporo 060-8543, Japan
| | - Takashi Fukagai
- Department of Urology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8666, Japan
| | - Kazuyoshi Shigehara
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
- Department of Urology, Ishikawa Prefectural Central Hospital, 2-1 Kuratsukihigashi, Kanazawa 920-8530, Japan
| | - Shizuko Takahara
- Innovative Clinical Research Center, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, Japan
- Medical Research Support Center, University of Fukui Hospital, 23-3 Shimoaizuki, Matsuoka Eiheiji-cho Yoshida-gun, Fukui 910-1193, Japan
| | - Yoshifumi Kadono
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| | - Atsushi Mizokami
- Department of Integrative Cancer Therapy and Urology, Kanazawa University Graduate School of Medical Science, 13-1 Takaramachi, Kanazawa 920-8641, Japan
| |
Collapse
|
5
|
Hatayama T, Tasaka R, Mochizuki H, Mita K. Comparison of surgical outcomes and split renal function between laparoscopic and robot-assisted partial nephrectomy: a propensity score-matched analysis. Int Urol Nephrol 2022; 54:805-811. [PMID: 35178639 DOI: 10.1007/s11255-022-03144-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/03/2022] [Indexed: 10/19/2022]
Abstract
PURPOSE The objective of this study was to compare perioperative outcomes and total and split renal function between laparoscopic partial nephrectomy (LPN) and robot-assisted partial nephrectomy (RAPN). Predictive risk factors of preservation of operated renal function were also assessed. METHODS We retrospectively analyzed 173 patients who underwent LPN (n = 84) or RAPN (n = 89) between 2010 and 2020. After propensity score matching (1:1), perioperative outcomes and total and split renal function were assessed. Logistic regression analysis was used to evaluate predictive risk factors of preservation of operated renal function. Trifecta criteria were defined as negative surgical margins, warm ischemia time (WIT) < 25 min, and no complications more than Clavien-Dindo grade II within 4 weeks after surgery. Split renal function was evaluated by mercaptoacetyltriglycine renal scan. RESULTS After propensity score matching, 42 patients were allocated to each group. RAPN was associated with significantly shorter WIT (RAPN vs LPN: 12 vs 22 min; p < 0.0001) and higher trifecta achievement rate (93.3 vs 64.2%; p < 0.0001). Other perioperative outcomes and total and split renal function were not significantly different between LPN and RAPN. The R.E.N.A.L. nephrometry score (RNS) was a predictive risk factor of preservation of operated renal function in the multivariable logistic regression analysis (odds ratio 1.68, 95% confidence interval 1.29-2.20, p < 0.0001). CONCLUSIONS RAPN improved WIT and trifecta achievement rate, but it did not improve the preservation of operated renal function, for which RNS was found to be a strong predictive risk factor.
Collapse
Affiliation(s)
- Tomoya Hatayama
- Department of Urology, Hiroshima City Asa Citizens Hospital, 2-1-1 Kabe-Minami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Ryo Tasaka
- Department of Urology, Hiroshima City Asa Citizens Hospital, 2-1-1 Kabe-Minami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Hideki Mochizuki
- Department of Urology, Hiroshima City Asa Citizens Hospital, 2-1-1 Kabe-Minami, Asakita-ku, Hiroshima, 731-0293, Japan
| | - Koji Mita
- Department of Urology, Hiroshima City Asa Citizens Hospital, 2-1-1 Kabe-Minami, Asakita-ku, Hiroshima, 731-0293, Japan.
| |
Collapse
|
6
|
Hatayama T, Hayashi T, Matsuzaki S, Masumoto H, Yanai H, Abdi H, Teishima J, Hasegawa Y. Successful treatment of recurrent small cell carcinoma of urinary bladder with pembrolizumab. IJU Case Rep 2020; 3:252-256. [PMID: 33163917 PMCID: PMC7609171 DOI: 10.1002/iju5.12208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/27/2020] [Accepted: 07/10/2020] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION Small cell carcinoma of urinary bladder is rare and has an aggressive malignant behavior and poor prognosis. Advanced bladder cancers are treated with immune checkpoint inhibitors, however, its efficacy for small cell carcinoma of urinary bladder is unclear. CASE PRESENTATION A 54-year-old female, diagnosed with clinical stage T2N0M0 small cell carcinoma of urinary bladder, underwent radical cystectomy after three cycles of etoposide-cisplatin neoadjuvant chemotherapy. Despite the fact that pathological examination revealed no residual carcinoma in bladder in her cystectomy specimen, local recurrence of a 60-mm mass detected in the follow-up investigation 7.5 months later. This was completely treated by pembrolizumab without any adverse effects. Immunohistochemical staining revealed that the tumor had no programmed death ligand 1 expression but it showed CD8-positive T-lymphocyte infiltration into the tumor. CONCLUSION Immune checkpoint inhibitors might have curative potentials for treatment of small cell carcinoma of urinary bladder.
Collapse
Affiliation(s)
- Tomoya Hatayama
- Department of UrologyNational Hospital Organization Fukuyama Medical CenterHiroshimaJapan
| | | | - Shinji Matsuzaki
- Department of UrologyNational Hospital Organization Fukuyama Medical CenterHiroshimaJapan
| | - Hiroshi Masumoto
- Department of UrologyNational Hospital Organization Fukuyama Medical CenterHiroshimaJapan
| | - Hiroyuki Yanai
- Department of PathologyOkayama University HospitalOkayamaJapan
| | - Hamidreza Abdi
- Department of SurgeryDivision of UrologyUniversity of OttawaOttawaOntarioCanada
| | - Jun Teishima
- Department of UrologyHiroshima University HospitalHiroshimaJapan
| | - Yasuhisa Hasegawa
- Department of UrologyNational Hospital Organization Fukuyama Medical CenterHiroshimaJapan
| |
Collapse
|
7
|
Mukai S, Shinmei S, Muto M, Hatayama T, Shikuma H, Miyamoto S, Fujii S, Sadahide K, Sekino Y, Hieda K, Inoue S, Hayashi T, Teishima J, Matsubara A. Refractory fistula of bladder repaired with transurethral cystoscopic injection of N-butyl-2-cyanoacrylate. IJU Case Rep 2020; 3:21-24. [PMID: 32743461 PMCID: PMC7292167 DOI: 10.1002/iju5.12130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 10/10/2019] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Refractory fistulas of the bladder are not rare, but they can rarely be closed naturally. Bladder fistulas can be treated in various ways. We report the case of an old woman who had a refractory fistula of the bladder that was able to be repaired with transurethral cystoscopic injection of N-butyl-2-cyanoacrylate. CASE PRESENTATION For decades after being treated for cervical cancer in 1970s, the woman frequently suffered from fevers. A computed tomography scan showed pelvic abscess at the left side of her bladder, and cystography showed urine leakage at the wall. Thus, we diagnosed her with a pelvic abscess due to a bladder fistula after radiation. Then, we treated her with drainage, antibiotic agents, and N-butyl-2-cyanoacrylate. After that, she no longer had fevers, and cystography showed no leakage of urine. CONCLUSION This result indicates transurethral cystoscopic injection of N-butyl-2-cyanoacrylate may treat bladder fistulas safely, minimally invasively, and quickly.
Collapse
Affiliation(s)
- Sakurako Mukai
- Department of UrologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
| | - Shunsuke Shinmei
- Department of UrologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
| | - Masayuki Muto
- Department of UrologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
| | - Tomoya Hatayama
- Department of UrologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
| | - Hiroyuki Shikuma
- Department of UrologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
| | - Shunsuke Miyamoto
- Department of UrologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
| | - Shinsuke Fujii
- Department of UrologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
| | - Kousuke Sadahide
- Department of UrologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
| | - Yohei Sekino
- Department of UrologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
| | - Keisuke Hieda
- Department of UrologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
| | - Shogo Inoue
- Department of UrologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
| | - Tetsutaro Hayashi
- Department of UrologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
| | - Jun Teishima
- Department of UrologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
| | - Akio Matsubara
- Department of UrologyHiroshima University Graduate School of Biomedical SciencesHiroshimaJapan
| |
Collapse
|
8
|
Shikuma H, Inoue S, Hatayama T, Mukai S, Muto M, Miyamoto S, Sadahide K, Fujii S, Sekino Y, Goto K, Shinmei S, Hieda K, Hayashi T, Teishima J, Matsubara A. Pneumatosis cystoides intestinalis linked to sunitinib treatment for renal cell carcinoma. IJU Case Rep 2019; 2:318-320. [PMID: 32743449 PMCID: PMC7292122 DOI: 10.1002/iju5.12119] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 08/09/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Pneumatosis cystoides intestinalis is a rare condition characterized by air-filled cysts within intestinal walls. It can be caused by various factors. We report a case of pneumatosis cystoides intestinalis linked to sunitinib treatment for renal cell carcinoma. CASE PRESENTATION A 67-year-old female with advanced renal cell carcinoma who had been treated with sunitinib visited our hospital complaining of abdominal pain. Computed tomography scans showed diffuse air-filled cystic formation of intestine. We treated with conservative therapy, and she recovered. However, although air-filled cysts disappeared in the images, intraoperative findings in the resection of a recurrent paracaval lymph node showed a thinning of the intestine. CONCLUSION It is necessary to consider pneumatosis cystoides intestinalis when a patient using a tyrosine kinase inhibitor complains of abdominal symptoms. It should also be noted that the effect of pneumatosis cystoides intestinalis may remain even if pneumatosis disappears from the image on tomography scans.
Collapse
Affiliation(s)
- Hiroyuki Shikuma
- Department of UrologyHiroshima University HospitalHiroshimaJapan
| | - Shogo Inoue
- Department of UrologyHiroshima University HospitalHiroshimaJapan
| | - Tomoya Hatayama
- Department of UrologyHiroshima University HospitalHiroshimaJapan
| | - Sakurako Mukai
- Department of UrologyHiroshima University HospitalHiroshimaJapan
| | - Masayuki Muto
- Department of UrologyHiroshima University HospitalHiroshimaJapan
| | | | - Kosuke Sadahide
- Department of UrologyHiroshima University HospitalHiroshimaJapan
| | - Shinsuke Fujii
- Department of UrologyHiroshima University HospitalHiroshimaJapan
| | - Yohei Sekino
- Department of UrologyHiroshima University HospitalHiroshimaJapan
| | - Keisuke Goto
- Department of UrologyHiroshima University HospitalHiroshimaJapan
| | - Shunsuke Shinmei
- Department of UrologyHiroshima University HospitalHiroshimaJapan
| | - Keisuke Hieda
- Department of UrologyHiroshima University HospitalHiroshimaJapan
| | | | - Jun Teishima
- Department of UrologyHiroshima University HospitalHiroshimaJapan
| | - Akio Matsubara
- Department of UrologyHiroshima University HospitalHiroshimaJapan
| |
Collapse
|
9
|
Hatayama T, Sekino Y, Shikuma H, Mukai S, Muto M, Miyamoto S, Sadahide K, Fukuoka K, Fuji S, Goto K, Shinmei S, Hieda K, Inoue S, Hayashi T, Teishima J, Kuroda N, Sentani K, Yasui W, Matsubara A. Case of renal mucinous tubular and spindle cell carcinoma with high nuclear grade. IJU Case Rep 2019; 2:193-196. [PMID: 32743410 PMCID: PMC7292185 DOI: 10.1002/iju5.12075] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 04/10/2019] [Indexed: 11/18/2022] Open
Abstract
Introduction Renal mucinous tubular and spindle cell carcinoma is a rare subtype of renal cell carcinoma newly added to the World Health Organization classification in 2004. Although it has been considered as a tumor with good prognosis, aggressive cases have recently been reported. Case presentation A 52‐year‐old man was diagnosed as having left renal cell carcinoma. Open radical left nephrectomy and left‐sided pelvic lymph nodes dissection were performed. Pathological diagnosis revealed a renal mucinous tubular and spindle cell carcinoma with high nuclear grade and extra‐regional lymph nodes metastasis classified as pT3aN0M1. After nephrectomy, metastasis at second lumbar vertebra and lymph nodes recurrence were occurred. Conclusion This tumor with high nuclear grade may be potentially aggressive and carries a poor prognosis.
Collapse
Affiliation(s)
- Tomoya Hatayama
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Yohei Sekino
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Hiroyuki Shikuma
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Sakurako Mukai
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Masayuki Muto
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Shunsuke Miyamoto
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Kosuke Sadahide
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Kenichiro Fukuoka
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Shinsuke Fuji
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Keisuke Goto
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Shunsuke Shinmei
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Keisuke Hieda
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Shogo Inoue
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Tetsutaro Hayashi
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Jun Teishima
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Naoto Kuroda
- Department of Diagnostic PathologyKochi Red Cross HospitalKochiJapan
| | - Kazuhiro Sentani
- Department of Molecular PathologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Wataru Yasui
- Department of Molecular PathologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Akio Matsubara
- Department of UrologyGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| |
Collapse
|
10
|
Otsuki T, Sakaguchi H, Hatayama T, Takata A, Hyodoh F, Tsujita S, Ueki A, Morimoto K. Secretory Ig a in Saliva and Academic Stress. Int J Immunopathol Pharmacol 2016; 17:45-8. [PMID: 15345191 DOI: 10.1177/03946320040170s208] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Several reports have proposed that the concentration of secretory immunoglobulin A (S-IgA) in saliva is an indicator of psychological stress. With this in mind, we decided to examine it in 10 second year medical student volunteers at Kawasaki Medical School course between May 4 and July 13, 2000 and discussed the relationship between S-IgA and the stress from academic examinations. Saliva was collected three times (on rising, at forenoon, and at bedtime) every Thursday. During this period, sporadic academic examinations were held twice and term-end examinations occurred during the last two weeks. Results showed the concentration of S-IgA significantly higher at the on rising time-point than at the other two time-points. There was also a tendency for the S-IgA level in saliva to be higher on the day before academic examinations and during them and lower on the days between these examinations. In addition, daily variations in the S-IgA concentration sometimes seemed to be disturbed by other academic stress. Therefore, it may be possible to use this measurement to monitor psychological stress in students and workers.
Collapse
Affiliation(s)
- T Otsuki
- Department of Hygiene, Kawasaki Medical School, Kurashiki, Okayama, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
11
|
Manabe H, Fujita S, Hatayama T, Ohkuma H, Suzuki S, Yagihashi S. Embolisation of Ruptured Cerebral Aneurysms with Interlocking Detachable Coils in Acute Stage. Interv Neuroradiol 2016; 3:49-63. [DOI: 10.1177/159101999700300106] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/1997] [Accepted: 01/20/1997] [Indexed: 11/16/2022] Open
Abstract
Twelve cases of ruptured cerebral aneurysm were treated in acute stage with interlocking detachable coils (IDC, Target Therapeutics, Fremont, California) and the outcome was assessed. IDCs were placed intra-aneurysm for intra-aneurysmal occlusion, or intra-artery for proximal occlusion. Cases: age 36–84 (mean; 60) y.o., 11 females and 1male; 1, 5, 4 and 2 patients were categorised (Hunt and Hess) as grades 1, 2, 3 and 4 respectively. An intra-aneurysmal occlusion in ten cases and a proximal occlusion in two were performed on day 1–11 (mean 4). On angiograms and CT findings, the ruptured point seemed to have occluded in all cases. The occlusion rate was 100% in five cases, 95% in two, 90% in three, 80% in one, and less than 50% in one. There were two cases of technical complication, one a coil migration and the other an aneurysmal perforation with IDC. Their Glasgow Outcome Scale six months after embolisation was graded as good recovery in four cases, moderately disabled state in two, severely disabled state in one, and dead in five. Follow-up angiograms taken four to six months after embolisation showed an intra-aneurysmal coil compaction in five cases. Two of these were treated by a second embolisation or by neck clipping followed by aneurysmal resection, but another two were observed without any treatment and the last one died of rebleeding. Histological examination of the resected embolised aneurysm revealed slight organization around coils but no endothelialisation over the aneurysmal orifice. In our experience, coil embolisation with IDC for acute ruptured aneurysm is a promising means of preventing rerupture during subacute stage.
Collapse
Affiliation(s)
| | | | | | | | | | - S. Yagihashi
- Department of Pathology, Hirosaki University School of Medicine, Hirosaki, Aomori
| |
Collapse
|
12
|
Hatayama T, Nakajima M, Hosaka K, Kainose K, Wakabayashi N, Tagami J. Stress distribution in resin-core build-up tooth under different load directions. Dent Mater 2015. [DOI: 10.1016/j.dental.2015.08.062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
13
|
Nagahata M, Kondo R, Saito S, Takemura A, Hatayama T. Which factors increase procedural thromboembolic events in patients with unruptured paraclinoid internal carotid artery aneurysm treated by coil embolization? Neuroradiol J 2011; 24:712-4. [PMID: 24059765 DOI: 10.1177/197140091102400507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2010] [Accepted: 01/03/2011] [Indexed: 11/17/2022] Open
Abstract
We analyzed the factors which increase the frequency of procedural thromboembolic events during coil embolization of unruptured paraclinoid internal carotid artery aneurysms. Neurologically symptomatic complications did not occur in our series. Silent hyperintense lesions on postoperative DWI were frequently detected after the coiling procedure in which we needed to withdraw the unreleased coil. Patient's age, sex, aneurysm diameter, packing density, use of balloon-assisted technique, and exchanging maneuver of microcatheter during the procedure did not increase the frequency of silent thromboembolic events.
Collapse
Affiliation(s)
- M Nagahata
- Department of Radiology and Radiation Oncology, Hirosaki University Graduate School of Medicine; Hirosaki, Japan -
| | | | | | | | | |
Collapse
|
14
|
Hayashi H, Maeda M, Murakami S, Kumagai N, Chen Y, Hatayama T, Katoh M, Miyahara N, Yamamoto S, Yoshida Y, Nishimura Y, Kusaka M, Fujimoto W, Otsuki T. Soluble Interleukin-2 Receptor as an Indicator of Immunological Disturbance Found in Silicosis Patients. Int J Immunopathol Pharmacol 2009; 22:53-62. [DOI: 10.1177/039463200902200107] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Silicosis patients (SILs) possess not only respiratory disorders but also alterations in autoimmunity. To determine an early indicator of immunological disturbance in SILs, the role of serum-soluble interleukin (IL)-2 receptor (sIL-2R) was analyzed. Of ten SILs, immunological clinical parameters such as immunoglobulin (Ig) G, complements, the titer of autoantibodies including anti-nuclear antibodies (ANA), anti-Scl-70 antibody (Ab) and anti-centromere (CM) Ab, and experimental indicators such as serum-soluble Fas, serum IL-2, CD25+ cells in CD4+ or CD8+ fractions, and sIL-2R were divided from respiratory parameters such as % vital capacity (%VC), percentage of forced expiratory volume in 1 second (FEV1.0%) and v25/Ht (liter/second/m(body height) by a correlation assay. Additionally, a stepwise regression test showed that sIL-2R was correlated with Ig G, ANA and anti-CM Ab. Furthermore, factor analysis revealed that sIL-2R contributed to the subpopulation of SILs with poorer immunological status in the absence of alterations in respiratory status. By defining healthy donors as 1, SILs as 2 and patients with systemic sclerosis as 3 for immunopathological progression status as metric variables, sIL2R and ANA showed a strong positive correlation. This suggests that sIL-2R is a good clinical indicator of immunological disturbance found in SILs without clinical manifestations of any disturbance in autoimmunity. Further analysis using a large-scale number of patients should be performed to confirm these findings.
Collapse
Affiliation(s)
- H. Hayashi
- Department of Hygiene, Kawasaki Medical School, Kurashiki
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - M. Maeda
- Department of Hygiene, Kawasaki Medical School, Kurashiki
| | - S. Murakami
- Department of Hygiene, Kawasaki Medical School, Kurashiki
| | - N. Kumagai
- Department of Hygiene, Kawasaki Medical School, Kurashiki
| | - Y. Chen
- Department of Hygiene, Kawasaki Medical School, Kurashiki
| | - T. Hatayama
- Department of Hygiene, Kawasaki Medical School, Kurashiki
| | - M. Katoh
- Department of Hygiene, Kawasaki Medical School, Kurashiki
| | - N. Miyahara
- Department of Hygiene, Kawasaki Medical School, Kurashiki
| | - S. Yamamoto
- Department of Hygiene, Kawasaki Medical School, Kurashiki
| | - Y. Yoshida
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - Y. Nishimura
- Department of Hygiene, Kawasaki Medical School, Kurashiki
| | | | - W. Fujimoto
- Department of Dermatology, Kawasaki Medical School, Kurashiki, Japan
| | - T. Otsuki
- Department of Hygiene, Kawasaki Medical School, Kurashiki
| |
Collapse
|
15
|
Wu P, Miura Y, Hyodoh F, Nishimura Y, Hatayama T, Hatada S, Sakaguchi H, Kusaka M, Katsuyama H, Tomita M, Otsuki T. Reduced function of CD4+25+ regulatory T cell fraction in silicosis patients. Int J Immunopathol Pharmacol 2006; 19:357-68. [PMID: 16831302 DOI: 10.1177/039463200601900212] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The quality and quantity of CD4+25+ regulatory T cells (Treg) in silicosis patients (SIL) were examined and compared with results from healthy donors (HD) because SIL often develop autoimmune diseases along with pulmonary disorders. Peripheral blood mononuclear cells from 57 SIL and 50 HD were analyzed for Treg. Treg frequency and clinical parameters were subjected to a factor analysis. Treg and CD4+25- T cells (Tneg) from five HD and five SIL, sorted by flow-cytometer, were used for functional assays of Treg, the expression pattern of Treg specific genes (FoxP3, GITR and CTLA-4) and activation-related genes (CD122 and CD123). Although the actual frequency of Treg did not differ between SIL and HD, the age-corrected level was reduced in SIL. The factor analysis showed that Treg frequency was positively associated with the serum level of IL-2. The inhibitory effect of Treg on Tneg activation was decreased when the Treg:Tneg ratio was 1:1/4 to 1/2. In addition, Treg dominancy of FoxP3 and CTLA-4 expression and Tneg dominancy of CD132 expression found in HD were lost in SIL. These results indicated that the Treg fraction in SIL may be substituted with chronically activated T cells due to recurrent exposure to silica, resulting in a reduction in the frequency and function of Treg. Since the reduction of Treg may precede the clinical manifestation, as silicosis may be a pre-clinical status for autoimmune diseases, control of Treg function using cell and/or gene therapy may be a good way to manage autoimmune disease.
Collapse
Affiliation(s)
- P Wu
- Department of Hygiene, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama 701-0192, Japan
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Hyodoh F, Takata-Tomokuni A, Miura Y, Sakaguchi H, Hatayama T, Hatada S, Katsuyama H, Matsuo Y, Otsuki T. Inhibitory Effects of Anti-Oxidants on Apoptosis of a Human Polyclonal T-Cell Line, MT-2, Induced by an Asbestos, Chrysotile-A. Scand J Immunol 2005; 61:442-8. [PMID: 15882436 DOI: 10.1111/j.1365-3083.2005.01592.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [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: 11/28/2022]
Abstract
To clarify the effects of silica and silicates on cellular features of lymphocytes, a human T-lymphotropic virus type-1-immortalized polyclonal T-cell line, MT-2, was exposed to various concentrations of chrysotile-A, an asbestos classified as silicate. MT-2 cells underwent apoptosis in a dose- and time-dependent manner. The mitochondrial apoptotic pathway was activated during chrysotile-A-induced apoptosis of MT-2 cells, because of the phosphorylation of JNK and p38, increase of BAX and release of cytochrome-c from mitochondria to cytoplasma. In addition, anti-oxidants such as hydroxyl-radical excluders and capturers of superoxide and inhibitors of superoxide production effectively reduced the size of the apoptotic fraction in MT-2 cells cultured with chrysotile-A. These results indicate that the activation of reactive oxygen species may play a central role in asbestos-induced T-cell apoptosis, and anti-oxidants may help to prevent complications of pneumoconiosis.
Collapse
Affiliation(s)
- F Hyodoh
- Department of Hygiene, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Otsuki T, Yata K, Takata-Tomokuni A, Hyodoh F, Miura Y, Sakaguchi H, Hatayama T, Hatada S, Tsujioka T, Sato Y, Murakami H, Sadahira Y, Sugihara T. Expression of protein gene product 9.5 (PGP9.5)/ubiquitin-C-terminal hydrolase 1 (UCHL-1) in human myeloma cells. Br J Haematol 2004; 127:292-8. [PMID: 15491288 DOI: 10.1111/j.1365-2141.2004.05205.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [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: 01/23/2023]
Abstract
The neuron cytoplasmic protein gene product 9.5 (PGP9.5)/ubiquitin-C-terminal hydrolase 1 (UCHL-1) protein is a thiol protease that recognizes and hydrolyzes a peptide bond at the C-terminal of ubiquitin, and is involved in the processing of ubiquitin precursors and ubiquinated proteins. Although this molecule is known as a specific tissue marker for the neuroendocrine system, many reports have indicated that PGP9.5 is a marker for certain tumour types, such as cancer of the lung, colon, and pancreas. The expression of PGP9.5 in myeloma cells was examined. PGP9.5 seemed to be expressed specifically in myeloma cells as compared with other haematological malignant cells. In addition, in myeloma cells subjected to growth-factor starvation, the upregulation of PGP9.5 was observed in association with that of p27(Kip1), a cyclin-dependent-kinase inhibitor, although the upregulation caused by irradiation was milder. In contrast, the hypoxic culture of myeloma cells induced down-regulation of PGP9.5. These results suggested that PGP9.5 may be a good marker for myeloma among haematological malignancies. In addition, it may indicate certain cellular features of myeloma cells, such as sensitivity to proteasome inhibitors.
Collapse
Affiliation(s)
- T Otsuki
- Department of Hygiene, Kawasaki Medical School, 577 Matsushima, Kurashiki, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Nagano M, Kai Y, Zou B, Hatayama T, Suwa M, Sasaki H, Kumagai S. The contribution of cardiorespiratory fitness and visceral fat to risk factors in Japanese patients with impaired glucose tolerance and type 2 diabetes mellitus. Metabolism 2004; 53:644-9. [PMID: 15131771 DOI: 10.1016/j.metabol.2003.11.023] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
It is still unclear as to how cardiorespiratory fitness and visceral fat accumulation contribute to coronary heart disease (CHD) risk factors in patients with diabetes mellitus. The purpose of the present study was to investigate whether cardiorespiratory fitness contributes to such risk factors independently of visceral fat accumulation. Two hundred Japanese patients (137 men and 63 women, aged 22 to 81 years) with impaired glucose tolerance (IGT) and type 2 diabetes mellitus (type 2 DM) without any intervention and pharmacological therapy participated in a cross-sectional study. The levels of fasting insulin, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and resting blood pressure were assessed. Maximal oxygen uptake (V.o(2max)), an index of cardiorespiratory fitness, was predicted by a graded exercise test using a cycle ergometer. Visceral fat area (VFA) was measured by computed tomography scan. The criteria for abnormalities of the risk factors were determined according to the standard values for Japanese. All subjects were divided equally into the following 3 groups according to their fitness level: low-fit (V.o(2max) < 32 mL/kg/min in men, V.o(2max) < 26 mL/kg/min in women), mid-fit (32 < or = V.o(2max) < 36 in men, 26 < or = V.o(2max) < 30 in women), and high-fit (V.o(2max) > or = 36 in men, V.o(2max) > or = 30 in women). The association between fitness level and the prevalence of abnormal values for these parameters was analyzed by a multiple logistic regression model adjusted for age and VFA. The odds ratio (OR) and 95% confidence interval (CI) for the prevalence of hyperinsulinemia were significantly lower in the mid-fit (OR = 0.35, 95% CI, 0.16 to 0.78) and in the high-fit groups (OR = 0.40, 95% CI, 0.16 to 0.98) compared with the low-fit group. In addition, ORs for the prevalence of low HDL-C in the mid-fit and high-fit groups were significantly lower (OR = 0.35, 95% CI, 0.14 to 0.86; and OR = 0.19; 95% CI, 0.08 to 0.60, respectively) than in the low-fit group. These results suggested that cardiorespiratory fitness might be one of the predictors of metabolic abnormalities, especially in patients with hyperinsulinemia and low HDL-C, independent of visceral fat accumulation in Japanese patients with IGT and type 2 DM.
Collapse
Affiliation(s)
- M Nagano
- Graduate School of Human-Environment Studies and Institute of Health Science, Kyushu University, Fukuoka, Japan
| | | | | | | | | | | | | |
Collapse
|
19
|
Ueki A, Isozaki Y, Tomokuni A, Hatayama T, Ueki H, Kusaka M, Shiwa M, Arikuni H, Takeshita T, Morimoto K. Intramolecular epitope spreading among anti-caspase-8 autoantibodies in patients with silicosis, systemic sclerosis and systemic lupus erythematosus, as well as in healthy individuals. Clin Exp Immunol 2002; 129:556-61. [PMID: 12197899 PMCID: PMC1906472 DOI: 10.1046/j.1365-2249.2002.01939.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Dysregulation of apoptosis through the Fas-Fas ligand pathway is relevant in autoimmune disease onset. We recently reported elevated serum levels of sFas in patients with silicosis, systemic sclerosis (SSC) and systemic lupus erythematosus (SLE), and proposed a block of apoptosis in the pathogenesis. The disturbance of apoptosis in lymphocytes including autoreactive clones could induce autoantibody production. Since autoantibodies directed against unknown antigens are present in the sera of these patients, the sera samples were examined for the presence of autoantibodies directed to caspase-8. Using Western blotting, autoantibodies against caspase-8 were detected in healthy individuals and in over 60% of patients. Using epitope mapping employing 12 amino acid polypeptides with SPOTs system, a minimum of 4 epitopes and a maximum of 13 were found, which implied that epitope spreading was in progress. It is noteworthy that two important catalytic cystein residues were included within the epitopes; firstly the active site cystein Cys287, and secondly Cys360 located in the unique pentapeptide motif QACQG. Using recombinant human caspase-8 linked protein chip array, autoantibodies were identified and molecular weight determined. The antibodies were mainly IgG; 80% were subclass IgG1(lambda); 20% were IgG4(kappa). Despite the ratio of human light chain kappa:lambda = 2:1, the predominance of IgG1(lambda) is noticeable. Anti-caspase-8 autoantibodies are detectable in healthy individuals and in patients suffering silicosis, SSc or SLE. A few epitopes were detected in healthy individuals compared to those suffering autoimmune diseases, indicating the intramolecular epitope spreading. Relationship of autoantibodies and the clinical background of the patients requires clarification.
Collapse
Affiliation(s)
- A Ueki
- Department of Hygiene, Kawasaki Medical School, Kurashiki, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Abstract
hsp105alpha is a stress protein characteristically highly expressed in the brain compared with other tissues in mammals. Here, to examine whether hsp105alpha plays a pivotal role in the nervous system, we tested the capability of hsp105alpha to protect against apoptosis in rat neuronal PC12 cells. Various stress treatments such as serum deprivation, heat shock, hydrogen peroxide, etoposide, and actinomycin D induced apoptosis in PC12 cells with characteristic shrinking of nuclei and chromatin. However, PC12 cells that constitutively overexpressed mouse hsp105alpha exhibited a strong protective effect against apoptosis induced by these stress treatments. Cleavage of poly(ADP-ribose) polymerase induced in PC12 cells by these treatments was inhibited in the constitutively overexpressed hsp105alpha cells. Furthermore, c-Jun N-terminal kinase (JNK) was activated in the cells treated with heat shock but not other treatments, and the heat-induced JNK activation was inhibited by the constitutive expression of hsp105alpha.Thus, hsp105alpha prevents not only heat-induced apoptosis by inhibiting JNK activation, but also prevents the apoptosis induced by other stressors through different pathways, and may play important roles in neuronal protection.
Collapse
Affiliation(s)
- T Hatayama
- Department of Biochemistry and Molecular Biology, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto, 607-8414, Japan.
| | | | | | | |
Collapse
|
21
|
Abstract
Stress proteins (heat shock proteins, HSP) play essential roles in folding, assembly and translocation of polypeptides and also in maintenance of the integrity of polypeptides as molecular chaperones. Since long-lasting hyperglycemia causes modification of cellular proteins, it is possible that expression of molecular chaperones may be altered during the course of diabetes. Here, we examined the cellular levels of stress proteins such as HSP105, HSP90 and HSC70/HSP70 in various tissues of streptozotocin-induced diabetic rats. In comparison to controls, the levels of HSC70 were markedly decreased in the liver but not in the brain, adrenal gland and pancreas of diabetic rats. The levels of HSP105 and HSP90 were not significantly changed in these tissues of diabetic rats. Furthermore, the induction of HSP70 as well as HSC70 by hyperthermia was significantly reduced in the liver and adrenal gland of diabetic rats. These results suggested that the expression and induction of HSC70/HSP70 may be altered during the course of diabetic disease and may result in impairment of the cytoprotective ability of diabetic rats.
Collapse
Affiliation(s)
- N Yamagishi
- Department of Biochemistry, Kyoto Pharmaceutical University, Japan
| | | | | | | |
Collapse
|
22
|
Yamane K, Shima T, Nishida M, Hatayama T, Yamanaka C, Toyota A, Hiramatsu K, Ishino S, Okada Y. [Hemodynamic effects of STA-MCA anastomosis on patients with occlusion of the main cerebral artery]. No Shinkei Geka 2001; 29:307-13. [PMID: 11344908] [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: 02/20/2023]
Abstract
PURPOSE We studied cerebral circulation in patients with occlusion of the main cerebral artery and investigated the efficacy of STA-MCA anastomosis. PATIENTS AND METHODS Thirty-six patients with occlusion of the main cerebral artery were studied. Twenty-three patients had occlusion of the internal carotid artery and 13 had occlusion of the middle cerebral artery. The mean age was 62 years. Cerebral blood flow (CBF) was measured in all patients and cerebrovascular reactivity (CVR) was examined in 11 patients by xenon enhanced CT. Intraoperatively, cortical arterial pressure and anastomotic flow were measured. RESULTS There was no perioperative mortality or morbidity. There was no ipsilateral stroke recurrence during the follow-up period averaging 35.1 months. Patency of the anastomosis was verified in 91% of the patients by magnetic resonance angiography. Twenty-three (64%) patients showed decreased CBF before the operation and 57% of these patients showed improvement to the normal range after STA-MCA anastomosis. All of the eight patients with decreased CVR showed improvement after the operation. Anastomotic flow correlated significantly with the cortical arterial pressure. CONCLUSION STA-MCA anastomosis could improve cerebral circulation of patients with low CBF or low CVR due to occlusion of the main cerebral arterial. It was concluded that STA-MCA anastomosis may contribute to the reduction of stroke recurrence, if perioperative complications are reduced.
Collapse
Affiliation(s)
- K Yamane
- Department of Neurosurgery, Chugoku Rosai Hospital, 1-5-1 Hirotagaya, Kure 737-0193, Japan
| | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Abstract
We investigated whether methylprednisolone sodium succinate can ameliorate cochlear nerve degeneration following compression injury on the cerebellopontine angle portion of the cochlear nerve, using a quantitative animal experimental model that we have developed recently. In this model, cochlear nerve degeneration after compression could be quantitatively evaluated, while cochlear ischemia induced by the compression carefully maintained below the critical limit that causes irreversible damage to the cochlea. Eleven rats were treated with methylprednisolone during the pre- and post-compression period. Two weeks after compression, the numbers of SGC were compared between the rats that received the compression without and with methylprednisolone treatment. Methylprednisolone treatment improved the survival of SGC following cochlear nerve injury statistically highly significantly in the basal turn where the traumatic stress had been less than in the other cochlear turns in our experimental setting. Although it was not statistically significant, greater survival was also observed in the other cochlear turns. The results of this experimental study indicated that at least a portion of injured cochlear nerve had been potentially treatable, and that methylprednisolone might prevent such cochlear neurons from entering into the vicious process of irreversible damaging process.
Collapse
Affiliation(s)
- T Sekiya
- Department of Neurosurgery, Hirosaki University School of Medicine, Hirosaki, Japan.
| | | | | | | |
Collapse
|
24
|
Okumura K, Osanai T, Kosugi T, Hanada H, Ishizaka H, Fukushi T, Kamada T, Miura T, Hatayama T, Nakano T, Fujino Y, Homma Y. Enhanced phospholipase C activity in the cultured skin fibroblast obtained from patients with coronary spastic angina: possible role for enhanced vasoconstrictor response. J Am Coll Cardiol 2000; 36:1847-52. [PMID: 11092655 DOI: 10.1016/s0735-1097(00)00966-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES We measured phospholipase C (PLC) activity in the cultured skin fibroblasts obtained from patients with and without coronary spasm and examined its correlation with coronary artery vasomotility. BACKGROUND Coronary artery vasomotility is enhanced in coronary spastic angina (CSA), but no information is available for the intracellular signaling. In spontaneously hypertensive rats, PLC activity in the skin fibroblasts has been shown to be enhanced. METHODS Skin fibroblasts obtained from 24 patients with CSA-14 with organic coronary artery disease (CAD) and 12 control subjects--were cultured by the explant method. Activity of PLC was determined by incubating the membrane fraction with 3H-phosphatidyl inositol bisphosphate and by quantifying 3H-inositol trisphosphate. In patients with CSA and control subjects, the relations between PLC activity and coronary artery basal tone and constrictor response to intracoronary acetylcholine (ACh) were examined. RESULTS Activity of PLC (pmol/protein [mg] per min) was 1.74+/-0.19 in patients with CSA; 0.90+/-0.12 in patients with CAD; and 0.65+/-0.07 in control subjects (p<0.001, patients with CSA vs. patients with CAD and control subjects; p = NS, patients with CAD vs. control subjects). According to the Lineweaver-Burk plot, Michaelis constant (micromol/liter) of PLC was 28+/-4 in patients with CSA; 49+/-14 in patients with CAD; and 56+/-10 in control subjects (p<0.05, patients with CSA vs. control subjects), whereas the maximal velocity was not different between the three groups. There were significant positive correlations between PLC activity and both basal tone (p = 0.0108) and response to ACh (p = 0.0053). Western blot analysis using membrane fraction demonstrated that 89% of PLC isoenzymes detected was of the delta1 isoform. CONCLUSIONS Because the PLC activity measured was genetically defined and was positively correlated with coronary artery vasomotility, enhanced PLC activity may be involved in the pathogenesis of coronary spasm.
Collapse
Affiliation(s)
- K Okumura
- Second Department of Internal Medicine, Hirosaki University School of Medicine, Japan.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Sekiya T, Hatayama T, Shimamura N, Suzuki S. Intraoperative electrophysiological monitoring of oculomotor nuclei and their intramedullary tracts during midbrain tumor surgery. Neurosurgery 2000; 47:1170-6; discussion 1176-7. [PMID: 11063111 DOI: 10.1097/00006123-200011000-00031] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE During surgery for intrinsic midbrain lesions, we intraoperatively recorded evoked compound muscle action potentials (ECMAPs) from the extraocular muscles and evaluated how this type of intraoperative electrophysiological monitoring could minimize postoperative oculomotor nerve palsy (ptosis and/or diplopia). METHODS The ECMAPs were recorded through a spring electrode applied to the extraocular muscle (Method 1, seven cases) or a needle electrode inserted into the superior intraorbital space (Method 2, five cases). The surgeon repeated electrical stimulations whenever tissue of unknown origin was encountered intraoperatively, and this information was used to safely guide surgical resection of the tumors. RESULTS Using these monitoring techniques, the response-free areas were resected and the areas from which ECMAP responses were recorded were avoided. For all 12 patients, ECMAPs were successfully recorded from the extraocular muscles. Ten patients did not exhibit any postoperative deterioration of oculomotor nerve function. Two patients exhibited deterioration of oculomotor nerve function immediately after surgery, which resolved within 1 month. Equally robust ECMAPs could be recorded with Method 2, compared with Method 1. CONCLUSION Intraoperative ECMAP recordings from the extraocular muscles precisely indicated the locations of the oculomotor nuclei and/or intramedullary oculomotor tracts. Although Method 2 is a more indirect method for recording ECMAPs than is Method 1, Method 2 was equally useful in recording ECMAPs, which seemed to be the summed potentials from the superior rectus muscle and the levator palpebrae superioris muscle. These monitoring techniques are valuable in guiding surgeons to avoid causing inadvertent harm to the oculomotor nuclei and tracts during midbrain surgery, particularly when the neuroanatomic features are distorted by the presence of tumor.
Collapse
Affiliation(s)
- T Sekiya
- Department of Neurosurgery, Hirosaki University School of Medicine, Japan.
| | | | | | | |
Collapse
|
26
|
Miyazaki A, Hatayama T. [Alleviation of sadness by pleasant imagery: analyses of subjective and physiological responses]. Shinrigaku Kenkyu 2000; 71:351-7. [PMID: 11140257 DOI: 10.4992/jjpsy.71.351] [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] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
This study examined whether elicitation of joy or relaxation would reduce intensity of formerly induced sadness by using imagery tasks. Participants (N = 10) imaged a series of four sad scenes successively in the preliminary experiment. Dependent variables were subjective emotional ratings, heart rate, and facial electromyography of the corrugator and the zygomatic muscles. The result indicated that the sadness-imageries increased heart rate, corrugator activity, and zygomatic activity, as well as sad feeling. The procedure of the main experiment (N = 19) was almost the same as that of the preliminary experiment except that the sadness-imageries were followed by one of the 3 emotional imageries, that is, relaxation, neutrality, and joy. The result indicated that the relaxation-imagery marginally significantly decreased the heart rate that had been increased by the sadness-imageries. The joy-imagery reduced sad feeling but increased the zygomatic activity more than the relaxation-imagery. No effect was found on the heart rate. These results suggested that positive emotions alleviate sadness, and that joy and relaxation alleviate different aspects of sadness.
Collapse
Affiliation(s)
- A Miyazaki
- Faculty of Humanity, Ibaraki University, Bunkyo, Mito 310-8512
| | | |
Collapse
|
27
|
Shima T, Yamane K, Nishida M, Hatayama T, Yamanaka C. Successful surgical treatment of a large mixed pial-dural arteriovenous malformation. J Clin Neurosci 2000; 7 Suppl 1:30-2. [PMID: 11013093 DOI: 10.1054/jocn.2000.0706] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A large mixed pial-dural arteriovenous malformation was successfully treated by surgical resection and occlusion of the draining veins. Treatment of this type of malformation is discussed.
Collapse
Affiliation(s)
- T Shima
- Department of Neurosurgery, Chugoku Rousai Hospital, Kure, Japan.
| | | | | | | | | |
Collapse
|
28
|
Sekiya T, Shimamura N, Hatayama T, Suzuki S. Effectiveness of preoperative administration of an N-methyl-D-aspartate antagonist to enhance cochlear neuron resistance to intraoperative traumatic stress: an experimental study. J Neurosurg 2000; 93:90-8. [PMID: 10883910 DOI: 10.3171/jns.2000.93.1.0090] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [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: 11/06/2022]
Abstract
OBJECT Cochlear neurons are inevitably exposed to traumatic stress during surgical removal of an acoustic neuroma; that event is an important cause of postoperative cochlear neuronal degeneration, with subsequent loss of spiral ganglion cells (SGCs). The object of this study was to investigate whether preoperative pharmacological treatment can enhance the resistance of cochlear neurons to the traumatic stress of surgery. METHODS Cochlear neuronal degeneration was induced in 17 rats by controlled compression of the cerebellopontine angle portion of the cochlear nerve. Dizocilpine maleate (MK-801; 10 mg/kg), an N-methyl-D-aspartate (NMDA) antagonist, was administered intraperitoneally to six of the 17 rats 30 minutes before compression occurred. Two weeks after compression, each rat was killed, and the numbers of SGCs in histological preparations of temporal bones were counted. CONCLUSIONS Spiral ganglion cells were more numerous in rats administered dizocilpine maleate (p < 0.03) than in rats that did not receive treatment, indicating that receptor-mediated glutamate neurotoxicity may participate in the pathogenesis of trauma-induced cochlear neuron death and that administration of an NMDA antagonist before surgery may protect the nerve from injury leading to hearing loss.
Collapse
Affiliation(s)
- T Sekiya
- Department of Neurosurgery, Hirosaki University School of Medicine, Japan.
| | | | | | | |
Collapse
|
29
|
Asano K, Sekiya T, Hatayama T, Tanaka M, Takemura A, Suzuki S, Kubo O, Ishihara Y. A case of endolymphatic sac tumor with long-term survival. Brain Tumor Pathol 2000; 16:69-76. [PMID: 10746963 DOI: 10.1007/bf02478905] [Citation(s) in RCA: 9] [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: 10/24/2022]
Abstract
A 72-year-old man developed left facial palsy at age 14 and left-sided hearing loss at age 20. At the age of 59, he presented with gait disturbance, and a large left cerebellopontine angle tumor was detected, which had markedly destroyed the pyramidal bone. The tumor was subtotally resected, but he required two more operations at the ages of 64 and 69 because of tumor regrowth. At the present time, recurrent tumor has destroyed the occipital bone and is invading the scalp. However, even though he has several cranial nerve palsies and cerebellar ataxia, he remains in stable condition and demonstrates long-term survival. The patient's surgical specimens revealed a papillary adenoma, which was recently thought to be of endolymphatic sac origin, although the origin of this kind of tumor, whether arising from the middle ear or from the endolymphatic sac, has not been established with certainty so far. In this paper, we provide further evidence that this tumor originates from the endolymphatic sac, based on anatomical, histopathological, and embryological evidence.
Collapse
Affiliation(s)
- K Asano
- Department of Neurosurgery, Hirosaki University, School of Medicine, Aomori Prefecture, Japan.
| | | | | | | | | | | | | | | |
Collapse
|
30
|
Yamagishi N, Nishihori H, Ishihara K, Ohtsuka K, Hatayama T. Modulation of the chaperone activities of Hsc70/Hsp40 by Hsp105alpha and Hsp105beta. Biochem Biophys Res Commun 2000; 272:850-5. [PMID: 10860841 DOI: 10.1006/bbrc.2000.2864] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hsp105alpha and Hsp105beta are stress proteins found in various mammals including human, mouse, and rat, which belong to the Hsp105/Hsp110 protein family. To elucidate their physiological functions, we examined here the chaperone activity of these stress proteins. Hsp105alpha and Hsp105beta prevented the aggregation of firefly luciferase during thermal denaturation, whereas the thermally denatured luciferase was not reactivated by itself or by rabbit reticulocyte lysate (RRL). On the other hand, Hsp105alpha and Hsp105beta suppressed the reactivation of thermally denatured luciferase by RRL and of chemically denatured luciferase by Hsc70/Hsp40 or RRL. Furthermore, although Hsp105alpha and Hsp105beta did not show ATPase activity, the addition of Hsp105alpha or Hsp105beta to Hsc70/Hsp40 enhanced the amount of hydrolysis of ATP greater than that of the Hsp40-stimulated Hsc70 ATPase activity. These findings suggest that Hsp105alpha and Hsp105beta are not only chaperones that prevent thermal aggregation of proteins, but also regulators of the Hsc70 chaperone system in mammalian cells.
Collapse
Affiliation(s)
- N Yamagishi
- Department of Biochemistry, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto, Japan
| | | | | | | | | |
Collapse
|
31
|
Sekiya T, Shimamura N, Hatayama T, Suzuki S. Cerebellopontine angle cisternal infusion of NGF, BDNF and NT-3: effects on cochlear neurons disconnected from central target, cochlear nucleus. An in vivo quantitative study. Acta Otolaryngol 2000; 120:473-9. [PMID: 10958397 DOI: 10.1080/000164800750045956] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Cochlear neurons need their synaptic contacts with both their peripheral (organ of Corti) and central (cochlear nucleus) targets for survival. We examined the in vivo effectiveness of the neurotrophins (NGF, BDNF and NT-3) on cochlear neuronal survival using our in vivo model, in which the central connection alone was selectively and quantitatively interrupted. The particular neurotrophins evaluated in the present study did not appear to have cochlear nerve rescue potential. However, the experimental model reported here can serve as a useful tool to investigate cochlear neuronal degeneration from the central side, which may lead to identification of effective mediators in the future.
Collapse
Affiliation(s)
- T Sekiya
- Department of Neurosurgery, Hirosaki University School of Medicine, Hirosaki, Japan.
| | | | | | | |
Collapse
|
32
|
Manabe H, Hatayama T, Hasegawa S, Islam SM, Suzuki S. Coil embolisation for ruptured vertebral artery dissection distal to the origin of the posterior inferior cerebellar artery. Neuroradiology 2000; 42:384-7. [PMID: 10872163 DOI: 10.1007/s002340050905] [Citation(s) in RCA: 26] [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: 11/27/2022]
Abstract
Although many surgical or endovascular treatments for ruptured vertebral artery dissection have been reported, the best treatment is controversial. We treated five cases of ruptured vertebral artery dissection distal to the origin of the posterior inferior cerebellar artery (PICA), using retrievable platinum coils packed in the dissection site and the immediately proximal vertebral artery. All patients had a contralateral vertebral artery of the same calibre or larger. All dissections were occluded completely, together with the portion of the vertebral artery distal to the PICA origin. No complications related to the procedure were seen. The purpose of the treatment is to isolate the dissection from the cerebral circulation. Occlusion of the rupture site, preserving perforating arteries arising from the vertebral artery, would be ideal. Short-segment occlusion by retrievable platinum coils is close to the ideal.
Collapse
Affiliation(s)
- H Manabe
- Department of Neurosurgery, Kuroishi City Hospital, Japan.
| | | | | | | | | |
Collapse
|
33
|
Ishihara K, Yasuda K, Hatayama T. Phosphorylation of the 105-kDa heat shock proteins, HSP105alpha and HSP105beta, by casein kinase II. Biochem Biophys Res Commun 2000; 270:927-31. [PMID: 10772927 DOI: 10.1006/bbrc.2000.2541] [Citation(s) in RCA: 12] [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: 11/22/2022]
Abstract
The 105-kDa heat shock protein alpha (HSP105alpha) and HSP105beta are mammalian heat shock proteins that belong to the HSP105/HSP110 family. Both HSP105alpha and HSP105beta consist of acidic and basic isoforms. Here we report that the acidic isoforms are serine phosphorylated HSP105alpha or HSP105beta. Furthermore, using an in-gel kinase assay with HSP105alpha or HSP105beta as the substrate, the protein kinase that phosphorylates HSP105alpha and HSP105beta was identified as casein kinase II. Since phosphorylated HSP105alpha is especially prominent in the brain compared to other tissues of mice and rats, the phosphorylation of HSP105alpha by casein kinase II may be biologically significant.
Collapse
Affiliation(s)
- K Ishihara
- Department of Biochemistry, Kyoto Pharmaceutical University, 5 Nakauchicho, Misasagi, Yamashina-ku, Kyoto, 607-8414, Japan
| | | | | |
Collapse
|
34
|
Abstract
Because traditional classifications of vestibular schwannomas (according to relative size) cannot comprehensively describe lesions that grow in different patterns after arising in regions as diverse as the cerebellopontine (CP) angle, the internal auditory canal, and the region lateral to the fundus of the internal auditory canal (labyrinth), we developed a new system to classify vestibular schwannomas, a system that describes the anatomical structures involved by the tumour, rather than size alone. The vestibular schwannoma is classified first by location and then by extent. Our system provides surgeons information helpful in choosing the surgical approach, in estimating the difficulty of tumour excision, and in determining whether hearing might be preserved. Our system also avoids confusion and misunderstanding in discussions of treatment results because it reflects the diverse biological characteristics of vestibular schwannomas.
Collapse
Affiliation(s)
- T Sekiya
- Department of Neurosurgery, Hirosaki University School of Medicine, Japan.
| | | | | | | |
Collapse
|
35
|
Abstract
In the available in vivo experimental models for cochlear neuronal degeneration, the peripheral (hair cell side) process of the cochlear nerve has been injured in order to induce neuronal degeneration. However, there has been no dependable experimental model in which cochlear neuronal degeneration begins from the central (brain stem side) process. This lack of a central process injury model has probably been due to the experimental difficulties that had to be overcome in order to reproducibly and selectively injure the central process of the cochlear neurons while maintaining the patency of the internal auditory artery in small experimental animals such as rats. Using rats, we first developed a central process injury model in which the reduction of the spiral ganglion cells due to retrograde degeneration of cochlear neurons can be quantitatively evaluated. In our experimental model, the cochlear nerve was compressed and injured by a compression-recording (CR) electrode placed at the internal auditory meatus. First, the cochlear nerve was compressed until the compound action potentials of the cochlear nerve became flat, and then the CR electrode was advanced by various compression speeds (5, 10, or 200 micrometer/s) to reach the same depth (400 micrometer). In our model, therefore, the reduction of the spiral ganglion cells was caused compression speed dependently. This method made it possible to produce compression injury to the cochlear nerve without evidence of damage to the blood supply to the cochlea via the internal auditory artery. This model gives us the means to obtain knowledge that was previously impossible to derive from the peripheral process injury models.
Collapse
Affiliation(s)
- T Sekiya
- Department of Neurosurgery, Hirosaki University School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8216, Japan
| | | | | | | |
Collapse
|
36
|
Yamane K, Shima T, Nishida M, Hatayama T, Yamanaka C. Changes in cerebral blood flow after carotid endarterectomy. Keio J Med 2000; 49 Suppl 1:A80-2. [PMID: 10750346] [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: 02/16/2023]
Abstract
We evaluated changes in cerebral blood flow (CBF) after carotid endarterectomy (CEA) in patients with internal carotid (ICA) stenosis. We studied 46 patients with ICA stenosis who underwent CEA. The mean age of the patients was 63 years, and their mean ICA stenosis was 73%. CBF in the middle cerebral artery territory was measured with xenon-enhanced CT tomography (Xe-CT) before and 3 weeks after CEA. In addition, cerebrovascular reactivity (CVR) was measured after intravenous administration of acetazolamide (ACZ) in 16 patients. There was no significant relationship between the degree of stenosis and CBF. Ten patients had decreased CBF before CEA, and CBF improved in nine of these after CEA. The CVR in 6 of 7 patients with impaired CVR before CEA improved to varying degrees after CEA. The CBF in patients with ICA stenosis varied according to the degree of collateral circulation. In conclusion, CEA can increase CBF and improve CVR in patients with low CBF or low CVR by restoring blood flow through the ICA.
Collapse
Affiliation(s)
- K Yamane
- Department of Neurosurgery, Chugoku Rosai Hospital, Hiroshima, Japan
| | | | | | | | | |
Collapse
|
37
|
Hatayama T, Manabe H, Hasegawa S, Baba S, Sekiya T, Suzuki S. [Electrophysiological mapping of the trigeminal nerve root during microvascular decompression for trigeminal neuralgia]. No Shinkei Geka 2000; 28:127-34. [PMID: 10666732] [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
A method for intraoperative electrophysiological mapping of the intracranial root of the trigeminal nerve was studied in five patients with trigeminal neuralgia. During surgery, the trigeminal nerve root was stimulated centrally with a bipolar electrode, and antidromic responses were recorded peripherally from three branches of the trigeminal nerve in the face. In all patients, the fibers of the individual subdivisions of the trigeminal nerve root were successfully localized based on the peripheral sites of antidromic response. This neural mapping was used during microvascular decompression in four patients and during a rhizotomy procedure in one patient. As a result of mapping, the fibers of the trigeminal division subserving the pain were clearly confirmed to be compressed by the artery in all four patients who were undergoing microvascular decompression. Likewise, the antidromic responses precisely identified the first division of the trigeminal nerve, which should be preserved to avoid postoperative corneal ulcers in patients undergoing rhizotomy. Based on these findings, it was concluded that this technique enables surgeons to precisely identify which fibers of the trigeminal nerve root should be decompressed or divided during surgery for trigeminal neuralgia.
Collapse
Affiliation(s)
- T Hatayama
- Department of Neurosurgery, Hirosaki University School of Medicine, Japan
| | | | | | | | | | | |
Collapse
|
38
|
Hatayama T, Hayakawa M. Differential temperature dependency of chemical stressors in HSF1-mediated stress response in mammalian cells. Biochem Biophys Res Commun 1999; 265:763-9. [PMID: 10600494 DOI: 10.1006/bbrc.1999.1751] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Expression of stress proteins is generally induced by a variety of stressors. To gain a better understanding of the sensing and induction mechanisms of stress responses, we studied the effects of culture temperature on responses to various stressors, since the induction of hsp70 in mammalian cells by heat shock is somehow modulated by culture temperature. Hsp70 was not induced by treatment with sodium arsenite, azetidine-2-carboxylic acid, or zinc sulfate at the level of heat shock factor (HSF) 1 activation in cells incubated at low temperature, although these treatments induced hsp70 in cells incubated at 37 degrees C. The repression of sodium arsenite or zinc sulfate-induced HSF1 activation by low temperature was not simply due to the inhibition of protein synthesis. On the other hand, heat shock and iodoacetamide induced HSF 1 activation in cells incubated at either temperature. Thus, there seem to be two kinds of stressors that induce HSF1 activation independently of or dependent on culture temperature. Furthermore, the reduction of glutathione level seemed to be essential for HSF1 activation by chemical stressors.
Collapse
Affiliation(s)
- T Hatayama
- Department of Biochemistry, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto, 607-8414, Japan.
| | | |
Collapse
|
39
|
Manabe H, Fujita S, Hatayama T, Suzuki S. Coil Embolization for Ruptured Dissection on the Vertebral Artery Distal to the Origin of Posterior Inferior Cerebellar Artery. Interv Neuroradiol 1999; 5 Suppl 1:187-90. [DOI: 10.1177/15910199990050s134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/1999] [Accepted: 09/30/1999] [Indexed: 11/16/2022] Open
Abstract
Although many surgical or endovascular treatments for ruptured vertebral dissection have been reported, the best treatment remains controversial. Recently endovascular vertebral occlusion using coils has been reported, the appropriate occlusion site has not yet been fully discussed. Five cases of ruptured vertebral dissection located distally to the origin of posterior inferior cerebellar artery were occluded by platinum coil packing in the angiographical “pearl” portion or “fusiform dilatation” together with its proximal vertebral artery. All dissections were occluded completely together with occlusion of distal portion of vertebral artery to PICA's origin. No complications related to procedure were seen in this series. Occlusion of rupture point with preserving tiny perforators arising from vertebral artery would be an ideal method for this lesion. The present cases suggest that the short segment occlusion by coil packing in the angiographical “pearl” portion or “fusiform dilatation” together with its proximal vertebral artery would be near to the ideal.
Collapse
Affiliation(s)
- H. Manabe
- Department of Neurosurgery; Hirosaki University School of Medicine
| | - S. Fujita
- Department of Neurosurgery; Hirosaki University School of Medicine
| | - T. Hatayama
- Department of Neurosurgery; Hirosaki University School of Medicine
| | - S. Suzuki
- Department of Neurosurgery; Hirosaki University School of Medicine
| |
Collapse
|
40
|
Hatayama T, Sekiya T, Suzuki S, Iwabuchi T. Effect of compression on the cochlear nerve: a short- and long-term electrophysiological and histological study. Neurol Res 1999; 21:599-610. [PMID: 10491823 DOI: 10.1080/01616412.1999.11740983] [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: 10/21/2022]
Abstract
The short- and long-term effects of static compression of the cochlear nerve were studied in dogs. The nerve was exposed in the cerebellopontine angle and a modified aneurysm clip was applied to reduce the diameter of the nerve trunk to 50%, 40%, 30% or 20% of normal (designated respectively as 50%, 60%, 70%, and 80% compression). Brainstem auditory evoked potentials (BAEPs) were monitored intraoperatively and post-operatively. The animals were sacrificed between 5 and 119 days after nerve compression and temporal bones were examined histologically. In the 50% compression group, all peaks except peak I disappeared immediately after nerve compression. After release of the clip, however, peak II and subsequent components recovered and prolonged interpeak latency (IPL) between peaks I and IV normalized within 7 days. In the 60% compression group, recovery was incomplete for as long as 49 days after compression. Significant histological changes were not always reflected in the electrophysiological recordings, as shown by the finding of multiple cavitations at the compressed portion of the cochlear nerve in cases in which conduction block of cochlear nerve impulses was reversible. In the 70% compression group, peak IV did not reappear for more than 1 week, and histological examination revealed severe damage to all cochlear nerve fibers except those from the apical turn, which lie in the center of the cochlear nerve trunk. Severe injury occurred to the cochlear nerve fibers that are situated more superficially in the nerve, which are tonotopically responsible for the perception of high-frequency sound and the generation of BAEPs. This means that the BAEP changes due to cochlear nerve compression would be detectable by BAEP monitoring, although changes in the apical region of the cochlea are not fully detectable by BAEP monitoring. In the 80% compression group, all peaks except peak I were lost permanently and the amplitude of peak I, which had been preserved in the acute phase, gradually decreased. Reversibility of impaired cochlear nerve impulse conduction was related to the severity of compression, and at some level of compression between 70% and 80% the nerve fibers generating BAEPs permanently lost the ability to conduct electrical impulses proximal to the site of compression. In the 70% and 80% compression groups, the amplitude of peak I gradually decreased over the first 30 days after compression and did not change significantly thereafter. Histologically, the branches of the internal auditory artery were resilient to compression, although they are easily avulsed due to stretch force. Furthermore, retrograde degeneration of cochlear neurons triggered by compression at the cisternal portion of the cochlear nerve was apparent. Such slowly progressive degeneration of nerve fibers may play a part in development of the delayed postoperative hearing disturbance.
Collapse
Affiliation(s)
- T Hatayama
- Department of Neurosurgery, Hirosaki University School of Medicine, Japan
| | | | | | | |
Collapse
|
41
|
Okada Y, Shima T, Nishida M, Yamane K, Hatayama T, Yamanaka C, Yoshida A. Comparison of transcranial Doppler investigation of aneurysmal vasospasm with digital subtraction angiographic and clinical findings. Neurosurgery 1999; 45:443-9; discussion 449-50. [PMID: 10493365 DOI: 10.1097/00006123-199909000-00005] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE Transcranial Doppler (TCD) findings for evaluation of the severity of vasospasm (VSP) in patients with ruptured aneurysmal subarachnoid hemorrhage are controversial. To clarify these TCD findings, intra-arterial digital subtraction angiography was used to simultaneously investigate the angiographic features of cerebral vessels and the cerebral circulation time (CCT). METHODS Fifty patients with ruptured aneurysms, for whom computed tomographic scans indicated Fisher Grade III subarachnoid hemorrhage, were investigated. Aneurysmal neck clipping was performed in the acute stage. The mean flow velocity (MFV) at the M1 segment was measured using TCD ultrasonography. Intra-arterial digital subtraction angiography was used to simultaneously investigate angiographic features and CCTs on Days 7 to 13. The CCT was defined as the time difference between the two peaks in optical density curves recorded at the carotid artery (C3-C4 portion) and the ascending vein, after contrast material injection. Angiographic VSP was categorized using a modification of the Fisher classification. RESULTS Angiograms for 9, 25, and 16 patients showed no, slight to moderate, and severe VSP, respectively. The MFVs of the patients with no, slight to moderate, and severe VSP were 70, 115, and 116 cm/s, respectively. No significant difference among the three groups could be observed. The mean CCTs of the patients with no, slight to moderate, and severe VSP were 4.1, 4.6, and 6.5 seconds, respectively. The CCTs of the patients with severe VSP differed significantly from those of the patients with no or slight to moderate VSP. The patients with severe VSP were divided into two groups. One group included eight patients with severe VSP at proximal sites (the internal carotid artery to the M1 segment), and the other included eight patients with severe VSP extending to the M2 segment and more peripheral sites. The mean CCT of the former group (5.3 s) was significantly different from that of the latter (7.5 s), and the MFV of the former group (128 cm/s) was significantly higher than that of the latter (81 cm/s). The clinical outcomes for the latter patients were more serious than those for the former patients. CONCLUSION This study suggests that the MFV at the M1 segment is inadequate for estimation of the severity of VSP extending to vessels more peripheral than the M1 segment. Furthermore, severe VSP extending to more peripheral sites can produce more serious ischemic insults, compared with that localized to basal vessels. Patients with negative TCD results and clinical features suggesting the development of VSP should undergo quantitative investigation of cerebral circulatory parameters, such as the CCT, using intra-arterial digital subtraction angiography.
Collapse
Affiliation(s)
- Y Okada
- Department of Neurosurgery, Shimane Medical University, Izumo, Japan
| | | | | | | | | | | | | |
Collapse
|
42
|
Hatayama T, Yamane K, Shima T, Okada Y, Nishida M. Persistent primitive hypoglossal artery associated with cerebral aneurysm and cervical internal carotid artery stenosis--case report. Neurol Med Chir (Tokyo) 1999; 39:372-5. [PMID: 10481441 DOI: 10.2176/nmc.39.372] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [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: 11/20/2022] Open
Abstract
A 71-year-old female had vertigo attacks once or twice a day secondary to vertebrobasilar insufficiency. Left carotid angiography revealed persistent primitive hypoglossal artery (PPHA) associated with a large internal carotid artery (ICA) aneurysm and severe stenosis of the ICA. The bilateral vertebral arteries were hypoplastic. The basilar artery was opacified via the PPHA but not via vertebral arteries. Clipping of the aneurysm was performed first because the risk of rupture of the aneurysm was not negligible. One month after clipping, carotid endarterectomy using a T-shaped shunt system was successfully performed. The postoperative course was uneventful and the vertebrobasilar ischemic attacks did not recur. Left carotid angiography demonstrated complete obliteration of the aneurysm and disappearance of the carotid artery stenosis. Low ICA flow (70 ml/min) and low stump pressure of the PPHA (25 mmHg) strongly suggested low perfusion of the posterior circulation. Carotid endarterectomy may be essential for augmentation of the posterior circulation in patients with PPHA associated with ICA stenosis.
Collapse
Affiliation(s)
- T Hatayama
- Department of Neurosurgery, Chugoku Rousai Hospital, Kure, Hiroshima
| | | | | | | | | |
Collapse
|
43
|
Hatayama T, Sekiya T, Ohkuma H, Shimamura N, Suzuki S, Yotsuyanagi T, Osari S. [Intraoperative electrophysiological monitoring for functional preservation of the cauda equina during lumbosacral surgery]. No Shinkei Geka 1999; 27:317-22. [PMID: 10347845] [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: 02/12/2023]
Abstract
Adequate electrophysiological techniques to monitor function of the cauda equina have been proposed for surgery in patients with lumbosacral lipoma or myeloschisis. Motor fibers were identified by electrical stimulation in the operating field with bipolar rectangular impulses of 200 mu sec duration at 2 Hz under 5 mA and compound muscle action potentials (CMAPs) recorded from the leg and anal muscles. By recording CMAPs from the tibialis anterior, the biceps femoris, the gastrocnemius, and the external anal sphincter muscles, all of the roots from the fourth lumbar to the fourth sacral segment were continuously monitored. To spare recording channels, recordings were obtained from the right versus the left side. In our institute, 5 patients have undergone lumbosacral surgery while using this monitoring system, and the results indicated that there was no postoperative neurological exacerbation in any of the cases. According to a combination of the CMAPs produced by stimulation, the segment of the stimulated motor root could be identified electrophysiologically. Monitoring of somatosensory evoked potentials was not performed because this would have required too much time and would have prolonged surgery. However, some sensory fibers, which appeared to be posterior roots of the cauda equina on intraoperative inspection, could be identified indirectly with CMAPs recording because of current spreading from the stimulation to motor fibers.
Collapse
Affiliation(s)
- T Hatayama
- Department of Neurosurgery, Hirosaki University School of Medicine, Japan
| | | | | | | | | | | | | |
Collapse
|
44
|
Yasuda K, Ishihara K, Nakashima K, Hatayama T. Genomic cloning and promoter analysis of the mouse 105-kDa heat shock protein (HSP105) gene. Biochem Biophys Res Commun 1999; 256:75-80. [PMID: 10066425 DOI: 10.1006/bbrc.1999.0283] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The 105-kDa heat shock protein (HSP105) is a member of the high-molecular-mass heat shock protein family. We have isolated and characterized the mouse HSP105 gene including about 1.2 kb of the 5'-flanking region. The mouse HSP105 gene spans about 22 kb, consisting of 18 exons separated by 17 introns. Southern blotting analysis revealed the existence of a single copy of HSP105. Primer extension analysis revealed that the transcription initiation site was located 165 bp upstream of the ATG translation initiation codon. The 5'-promoter region of the HSP105 gene contained a TATA box, a CAAT box, an inverted CAAT box, and two GC boxes. Two heat shock element (HSE) sequences were found as four nGAAn repeats at nt -64 and nt -128. Promoter analysis using deletion derivatives revealed that a minimal region which contained the two consensus HSE sequences was active in response to heat shock and also for constitutive expression of the gene.
Collapse
Affiliation(s)
- K Yasuda
- Department of Biochemistry, Kyoto Pharmaceutical University, Kyoto, 607-8414, Japan
| | | | | | | |
Collapse
|
45
|
Abstract
We have shown that the 105 kDa heat shock protein (hsp105alpha) and hsp105beta (42 degreesC-specific heat shock protein) constitute high molecular mass (HMM) heat shock proteins (HSPs) in mouse cells. However, since HMM HSPs have not been identified in human cells, we screened a cDNA library constructed with poly(A)+ RNA derived from heat-shocked human HeLa cells using mouse hsp105alpha cDNA. Two full-length cDNA clones were obtained: the pBH105-1 insert encoded an 858-amino-acid protein, and the pBH105-2 insert encoded an 814-amino-acid protein which lacked 44 amino acids from pBH105-1. The deduced amino acid sequences of pBH105-1 and pBH105-2 inserts were highly homologous to mouse hsp105alpha (96%) and hamster hsp110 (92%), and to mouse hsp105beta (93%), respectively. The transcript of pBH105-1 was induced by various stresses in HeLa cells, but the transcript of pBH105-2 was only induced during heat shock at 42 degreesC. These results indicated that pBH105-1 and pBH105-2 encoded human hsp105alpha and hsp105beta, respectively. Furthermore, a rabbit antibody was raised against recombinant human hsp105alpha, and immunofluorescence study also confirmed that hsp105 was present in the cytoplasm but was not found in the nucleoli of mammalian cells under both nonstressed and stressed conditions.
Collapse
Affiliation(s)
- K Ishihara
- Department of Biochemistry, Kyoto Pharmaceutical University, 5 Nakauchi-cho, Misasagi, Yamashina-ku, Kyoto 607-8414, Japan
| | | | | |
Collapse
|
46
|
Nishida M, Shima T, Okada Y, Yamane K, Hatayama T, Yamanaka C, Toyota A, Nishida T. [Macroscopic and pathohistological investigation of endarterial plaque after intraoperative balloon dilatation of the carotid artery during carotid endarterectomy]. No Shinkei Geka 1998; 26:1075-82. [PMID: 9883446] [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: 02/09/2023]
Abstract
Twelve patients associated with stenosis of the extracranial carotid artery underwent intraluminal balloon dilatation during carotid endarterectomy (CEA). There were 11 men and 1 woman, and age ranged from 56 to 73 years old. The rate of stenosis, shown by angiography, in each patient was from 60 to 85% in width. After securing carotid blood flow by a T-shaped shunt tube, a balloon catheter was inserted from the exposed common carotid artery into the internal carotid artery. The balloon was inflated three or four times with 2.5-3.5 atm. for 30-40 seconds. Immediately after balloon dilatation, endoscopic investigation was performed (Wolf; hard type endoscope, 2.7 mm diameter). Then CEA was performed using the usual procedure. The removed endarterial plaque was investigated pathohistologically. In macroscopic and endoscopic findings, there were 6 patients with mural thrombosis, 4 patients with laceration of the intima, and one patient with outflow of atheroma from the intima. Only 3 patients had increase in lumen after balloon dilatation. In pathohistological appearance, all patients had a moderate degree of fibrosis, calcification, and atheroma in the cross section of the plaque. Ten patients had intramural hemorrhage. Three typical patients were revealed by the use of angiographical, ultrasonographical, endoscopic, and pathohistological presentation. Case 10 showed laceration of the intima by balloon dilatation, and had moderate increase in lumen size macroscopically and endoscopically. There were moderate cases of fibrosis, calcification, atheroma, and intramural hemorrhage. Dilatation of the lumen seemed to be accomplished by a decrease in thickness of the atheroma and intramural hemorrhage. Case 8 demonstrated an increase in lumen size, but also laceration of the intima and outflow of atheroma from the arterial wall. There were much atheroma and large intramural hemorrhage in the intima, which might become a source of enbolism. Case 7 revealed no laceration of the intima and no increase in lumen size. Preoperative ultrasonography showed hyperechoic finding and postoperative pathohistological findings showed severe fibrosis and calcification, which were thought to have interrupted balloon dilatation. There have been small numbers of reports about pathohistological presentation after percutaneous transluminal angioplasty (PTA), because it is very difficult to take a specimen after PTA. In this report we were able to present the necessity of preoperative investigations by angiography, ultrasonography, and 3D-CT.
Collapse
Affiliation(s)
- M Nishida
- Department of Neurosurgery, Chugoku Rousai Hospital, Kure-shi, Japan
| | | | | | | | | | | | | | | |
Collapse
|
47
|
Manabe H, Fujita S, Kimura M, Hatayama T, Suzuki S. A Case of Partially Thrombosed Giant Basilar Aneurysm Successfully Treated by Coil Embolization Followed by Proximal Clipping. Interv Neuroradiol 1998; 4 Suppl 1:85-8. [DOI: 10.1177/15910199980040s117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/1998] [Accepted: 08/25/1998] [Indexed: 11/17/2022] Open
Abstract
A case of unclippable partially thrombosed giant basilar artery (BA) aneurysm was treated successfully by intra-aneurysmal GDC embolization followed by proximal BA occlusion. Balloon occlusion test of the BA showed a good opacification of the aneurysm angiographically through plentiful collateral flow from anterior circulation. This combination may prevent coil compaction and will promote intra-aneurysmal thrombosis.
Collapse
Affiliation(s)
- H. Manabe
- Department of Neurosurgery, Hirosaki University School of Medicine; Hirosaki, Japan
| | - S. Fujita
- Department of Neurosurgery, Hirosaki University School of Medicine; Hirosaki, Japan
| | - M. Kimura
- Department of Neurosurgery, Hirosaki University School of Medicine; Hirosaki, Japan
| | - T. Hatayama
- Department of Neurosurgery, Hirosaki University School of Medicine; Hirosaki, Japan
| | - S. Suzuki
- Department of Neurosurgery, Hirosaki University School of Medicine; Hirosaki, Japan
| |
Collapse
|
48
|
Hatayama T, Møller AR. Correlation between latency and amplitude of peak V in the brainstem auditory evoked potentials: intraoperative recordings in microvascular decompression operations. Acta Neurochir (Wien) 1998; 140:681-7. [PMID: 9781282 DOI: 10.1007/s007010050163] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Intraoperative prolongation of the latency and decrement of the amplitude of peak V of brainstem auditory evoked potentials (BAEP) were studied in 38 microvascular decompression operations in which prolongation of the latency of peak V exceeded 1.0 msec. Postoperative hearing tests of all patients were compared with their preoperative hearing tests. Postoperative hearing loss was unrelated to the maximum prolongation of latency, but the amplitude decreased to lower values in patients with postoperative hearing loss compared to patients whose postoperative hearing was unchanged (P < 0.05). Twelve (32%) of 38 patients whose latency of peak V was prolonged more than 1.0 msec and 11 (61%) of 18 patients whose amplitude of peak V decreased more than 40% during the operations had decreased hearing postoperatively. In all patients, a prolongation of the latency of peak V was always accompanied by a decrease in the amplitude of peak V. The decrement of the amplitude was greater in the patients with decreased postoperative hearing thresholds than in the patients with unchanged postoperative hearing thresholds. The results of this study indicate that it would be valuable to monitor changes in the amplitude of peak V of BAEP in addition to monitoring the latency of peak V during operations where the VIIIth cranial nerve is manipulated.
Collapse
Affiliation(s)
- T Hatayama
- Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pennsylvania, USA
| | | |
Collapse
|
49
|
Wakatsuki T, Hatayama T. Characteristic expression of 105-kDa heat shock protein (HSP105) in various tissues of nonstressed and heat-stressed rats. Biol Pharm Bull 1998; 21:905-10. [PMID: 9781836 DOI: 10.1248/bpb.21.905] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [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: 11/22/2022]
Abstract
Although the induction of heat shock proteins (HSP) has been studied extensively in cultured cells, comparatively few studies have examined their expression in vivo. In this report, we investigated the expression and the state of 105-kDa heat shock protein (HSP105) in various tissues of rats, and found that two isoforms of HSP105 (HSP105-a and HSP105-b) were both moderately expressed in adrenal, spleen, liver and heart, and both increased markedly after heat shock. However, in brain HSP105-a was characteristically highly expressed over HSP105-b, but neither increased after heat shock. In addition, a 100-kDa protein (p100), a possible testis-specific HSP105 homologue was found in testis. When the effects of adrenaline and its antagonists on the heat-inducibility of HSP105 were examined, the induction of HSP105 in adrenal gland seemed to be negatively regulated through the alpha-adrenergic receptor. Furthermore, HSP105 was found to be associated with HSC70/HSP70, and to exist as high molecular mass complexes of 300-800-kDa and of 300-500-kDa in various tissues of nonstressed and heat-stressed rats, respectively. The molecular interaction between HSP105 and HSC70 suggests the possibility that HSP105 functions with HSC70 cooperatively in various tissues of rats.
Collapse
Affiliation(s)
- T Wakatsuki
- Department of Biochemistry, Kyoto Pharmaceutical University, Japan
| | | |
Collapse
|
50
|
Abstract
The 105-kDa stress proteins HSP105alpha and HSP105beta belong to a high molecular mass heat shock protein family which has been found in organisms from yeast to mammals. Here we demonstrated the interaction of HSP105 with HSP70 family proteins in mouse FM3A cells. The association of HSP105 with HSC70 was shown by immunoprecipitation using anti-HSP105 antibody. Furthermore, when cell extracts or partially purified HSP105 fractions from nonstressed or heat-shocked cells were analyzed by size exclusion chromatography, density gradient centrifugation or cross-linking, HSP105 was detected as HSP105/HSC70 complexes with molecular masses of approximately 300-500-kDa, 160-kDa or 200-kDa, respectively. Since the 160-200-kDa complexes must be HSP105/HSC70 heterodimers, the 300-500-kDa complexes seemed to consist of HSP105/HSC70 heterotetramers possibly with other proteins. Our finding that HSP105 is complexed with HSC70 suggests that HSP105 may function cooperatively with HSC70, that HSP105 regulates the function of HSC70 or that HSC70 reversibly regulates the function of HSP105 in cells under both nonstressed and stressed conditions.
Collapse
Affiliation(s)
- T Hatayama
- Department of Biochemistry, Kyoto Pharmaceutical University, Yamashina-ku, Kyoto, 607-8414, Japan.
| | | | | |
Collapse
|