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Tezuka Y, Akao M, Suzuki S, Yamashita T, Kodani E, Tsuda T, Hayashi K, Furusho H, Sawano M, Fukuda K, Nakai M, Sasahara Y, Miyamoto Y, Tomita H, Okumura K. Usefulness of echocardiographic parameters in predicting the incidence of ischemic stroke in Japanese patients with non-valvular atrial fibrillation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) is a risk factor for ischemic stroke (IS). We developed a novel risk score of IS (HELT-E2S2 score) in non-valvular atrial fibrillation (NVAF) patients from the combined database of 5 major AF registries in Japan. However, this score does not include echocardiographic (Echo) parameters that have been reported to be risk factors of IS, such as left atrial diameter (LAD) enlargement or increased relative wall thickness (RWT) of left ventricle (LV).
Purpose
To investigate the predictive value of Echo parameters in Japanese patients with NVAF.
Methods
After excluding patients without the Echo data, 6,032 NVAF patients were analyzed in the present study. LAD was measured in the parasternal long axis view at the end-ventricular systole. RWT was calculated as (2x posterior wall thickness)/ LV end-diastolic dimension. We compared clinical characteristics and the incidence of IS between NVAF patients divided by LAD level (High/Low LAD group) and RWT level (High/Low RWT group). To balance the follow-up period among the registries, event data from individuals whose follow-up period exceeded 730 days were excluded from the analysis.
Results
The optimal cut-off value of LAD and RWT to predict the incidence of IS with the receiver operating characteristic analysis was 43.3 mm and 0.4167, respectively. Between the High/Low LAD groups (High LAD: n=2,640 vs. Low LAD: n=3,392), age (70.3±12.1 vs. 68.3±12.5 years; p<0.001), CHA2DS2-VASc score (3.02±1.84 vs. 2.57±1.78; p<0.001), HELT-E2S2 score (2.20±1.31 vs. 1.55±1.33; p<0.001), the prescription of oral anticoagulants (OACs) (69.5 vs. 51.5%; p<0.001), LV ejection fraction (60.4±13.4 vs. 64.4±10.7%; p<0.001) and RWT (0.401±0.091 vs. 0.396±0.082; p=0.02) were significantly different. Between the High/Low RWT groups (High RWT: n=2,293 vs. Low RWT: n=3,739), percentage of female (35.6 vs. 27.8%; p<0.001), age (71.2±12.1 vs. 68.0±12.4 years; p<0.001), CHA2DS2-VASc score (3.08±1.82 vs. 2.58±1.79; p<0.001), HELT-E2S2 score (2.10±1.39 vs. 1.67±1.31; p<0.001), the prescription of OACs (62.6 vs. 57.4%; p<0.001), LV ejection fraction (65.5±9.9 vs. 60.9±13.0%; p<0.001) and LAD (43.0±8.1 vs. 42.4±8.3; p=0.004) were significantly different. In Kaplan-Meier analysis, the incidence of IS was different between the groups during the median follow-up period of 730 days (High LAD vs. Low LAD; 1.82 vs. 1.00 per 100 person-years; p<0.001, by log-rank test, High RWT vs. Low RWT; 1.86 vs. 1.06; p<0.001) (Figure). Both High LAD (hazard ratio: 1.65, 95% CI: 1.12–2.46; p=0.01) and High RWT (hazard ratio: 1.43, 95% CI: 1.01–2.04; p=0.045) were independent predictors of the incidence of IS after adjustment by the components of the HELT-E2S2 score and other clinically relevant variables including co-existing diseases, gender, and the prescription of OACs (Table).
Conclusion
Echo parameters, LAD and RWT, were independently associated with the incidence of IS among Japanese patients with NVAF.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Japan Agency for Medical Research and Development
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Affiliation(s)
- Y Tezuka
- Mitsubishi Kyoto Hospital , Kyoto , Japan
| | - M Akao
- Kyoto Medical Center, Department of Cardiology , Kyoto , Japan
| | - S Suzuki
- Cardiovascular Institute, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Yamashita
- Cardiovascular Institute, Department of Cardiovascular Medicine , Tokyo , Japan
| | - E Kodani
- Nippon Medical School Hospital, Department of Internal Medicine and Cardiology , Tokyo , Japan
| | - T Tsuda
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine , Kanazawa , Japan
| | - K Hayashi
- Kanazawa University Graduate School of Medicine, Department of Cardiovascular Medicine , Kanazawa , Japan
| | - H Furusho
- Kanazawa University, Department of Cardiovascular Medicine , Kanazawa , Japan
| | - M Sawano
- Keio University School of Medicine, Department of Cardiovascular Medicine , Tokyo , Japan
| | - K Fukuda
- Keio University School of Medicine, Department of Cardiovascular Medicine , Tokyo , Japan
| | - M Nakai
- National Cerebral & Cardiovascular Center, Center for Cerebral and Cardiovascular Disease Information , Suita , Japan
| | - Y Sasahara
- National Cerebral & Cardiovascular Center, Center for Cerebral and Cardiovascular Disease Information , Suita , Japan
| | - Y Miyamoto
- National Cerebral & Cardiovascular Center, Center for Cerebral and Cardiovascular Disease Information , Suita , Japan
| | - H Tomita
- Hirosaki University Graduate School of Medicine, Department of Cardiology , Hirosaki , Japan
| | - K Okumura
- Hirosaki University Graduate School of Medicine, Department of Cardiology , Hirosaki , Japan
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Akao M, Ogawa H, Suzuki S, Yamashita T, Kodani E, Tsuda T, Hayashi K, Furusho H, Sawano M, Fukuda K, Nakai M, Miyamoto Y, Tomita H, Okumura K. P3755Left atrial enlargement as an independent risk factor for ischemic stroke in Japanese atrial fibrillation patients: pooled analysis of five major Japanese atrial fibrillation registries. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Atrial fibrillation (AF) increases the risk of ischemic stroke. It remains unknown whether left atrial diameter determined by routine trans-thoracic echocardiography is a risk factor for ischemic stroke in non-valvular AF (NVAF) patients.
Purpose
The aim of this study is to investigate the impact of left atrial enlargement (LAE) on the incidence of ischemic stroke in a large-scale cohort of Japanese NVAF patients.
Methods
We combined the data of 5 major AF registries in Japan, J-RHYTHM Registry, Fushimi AF Registry, Shinken Database, Keio interhospital Cardiovascular Studies, and Hokuriku AF Registry. After excluding patients without echocardiographic data, 7,672 NVAF patients were analyzed in the present study (mean age, 69.3±12.3 years; mean CHADS2 score, 1.6±1.3). We compared clinical characteristics and the incidence of ischemic stroke between NVAF patients with LAE (left atrial diameter >45 mm; LAE group) and those without (non-LAE group).
Results
The mean left atrial diameter was 43.1±8.6 mm, and the LAE group accounted for 40.0% (n=3,066) of the entire cohort. Compared with non-LAE group (60.0%, n=4,606), the LAE group was older (LAE vs. non-LAE; 70.3±12.0 vs. 68.0±12.5, p<0.01), more often non-paroxysmal type (73.7% vs. 32.1%, p<0.01), had higher CHADS2 (1.86±1.34 vs. 1.46±1.29, p<0.01) and CHA2DS2-VASc (3.02±1.83 vs. 2.53±1.78, p<0.01) scores, and more frequently received oral anticoagulant (72.9% vs. 55.0%, p<0.01).
During the median follow-up period of 774.5 days (interquartile range: 567–1466 days), ischemic stroke occurred in 241 patients (131 vs. 110 patients; 1.52 vs. 0.82 per 100 person-years). In Kaplan Meier analysis, LAE was associated with a higher incidence of ischemic stroke (unadjusted hazard ratio (HR): 1.83, 95% confidence interval (CI): 1.42–2.36; log rank p<0.01) (Figure). LAE was independently associated with increased risk of ischemic stroke (adjusted HR: 1.63, 95% CI: 1.25–2.11; p<0.01) after adjustment by the components of CHADS2 score and the use of oral anticoagulant, on multivariate Cox proportional hazard analysis.
Conclusion
In this large-scale cohort of Japanese patients with AF, LAE was an independent predictor of ischemic stroke, suggesting that this simple echocardiographic parameter could refine thromboembolic risk stratification of NVAF patients.
Acknowledgement/Funding
Japan Agency for Medical Research and Development, AMED
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Affiliation(s)
- M Akao
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - H Ogawa
- Kyoto Medical Center, National Hospital Organization, Kyoto, Japan
| | - S Suzuki
- Cardiovascular Institute, Tokyo, Japan
| | | | - E Kodani
- Nippon Medical School, Tama-Nagayama Hospital, Tama, Japan
| | - T Tsuda
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - K Hayashi
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - H Furusho
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | | | | | - M Nakai
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Y Miyamoto
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - H Tomita
- Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - K Okumura
- Saiseikai Kumamoto Hospital, Kumamoto, Japan
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Endo A, Sawano M, Ikemura N, Takei M, Suzuki K, Hasegawa T, Takahashi T, Nakagawa S, Fukuda K, Kohsaka S. P684Long-term outcomes in patients with cancer undergoing percutaneous coronary intervention: analysis from a Japan multicenter registry. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cancer and cardiovascular disease (CVD) is the most common cause of death in developed countries, and substantial overlap exist in their medical care. However, the detailed and updated information on outcome of cancer patients with cardiovascular disease (CVD), particularly in clinically significant coronary artery disease (CAD) remain unknown.
Purpose
We sought to describe the prevalence and long-term outcomes of cancer patients undergoing percutaneous coronary intervention (PCI), which has become a coronerstone in the management of CVD.
Methods
Patient data extracted from a regional prospectiveprocedure-based multicenter registry for PCI was analyzed. A total of 4,455 patients who underwent PCI at 15 hospitals within metropolitan Tokyo from September 2008 to 2012 were followed for 2 years. “Active” cancer patient was defined as having a history of cancer not cured or in remission. We analyzed in acute and stable presentation.The occurrence of clinical outcomes was assessed via Kaplan-Meier survival curve, and Cox-regression hazard model to adjust for known clinical predictors.
Results
Within the studied patients, 173 (3.9%) had a concomitant “active” cancer at the time of intervention. There was a significant difference between the patients with and without active cancer in each situation. In stable presentation, cancer group were older, lower BMI, frequently had silent ischemia, COPD and cerebrovascular/peripheral disease, and less often had dyslipidemia compared with non-cancer group. In acute presentation, cancer group were older, frequently had COPD, CKD, peripheral disease and history of HF compared with non-cancer group. The prescription rate of RAAS inhibitor was lower in the cancer group than in the non-cancer group in acute presentation. Notably, in both acute and stable presentation, these patients had significantly higher risk of all-cause mortality (HR 8.01: 95%, p<0.001 and HR5.53: 95%, p<0.001, respectively), and they were also at higher risk of major cardo- and cerebrovascular events (MACCE; HR2.38, p<0.001, HR2.33, p=0.001), when referenced to non-cancer patients after 2 year of follow-up.
Conclusion
Cancer patient was present in 3.9% of all PCI patients and was strongly associated with both non-cardiac and cardiac adverse events.
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Affiliation(s)
- A Endo
- Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - M Sawano
- Keio University School of Medicine, Cardiology, Tokyo, Japan
| | - N Ikemura
- Keio University School of Medicine, Cardiology, Tokyo, Japan
| | - M Takei
- Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - K Suzuki
- Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - T Hasegawa
- Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - T Takahashi
- Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - S Nakagawa
- Tokyo Saiseikai Central Hospital, Tokyo, Japan
| | - K Fukuda
- Keio University School of Medicine, Cardiology, Tokyo, Japan
| | - S Kohsaka
- Keio University School of Medicine, Cardiology, Tokyo, Japan
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Shoji S, Sawano M, Shiraishi Y, Ikemura N, Noma S, Suzuki M, Numasawa Y, Fukuda K, Kohsaka S. P6531Evidence-practice gap in the preprocedural risk assessment for contrast-induced acute kidney injury. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Contrast-induced acute kidney injury (CI-AKI) is one of the frequently encountered and costly complications after percutaneous coronary intervention (PCI). Clinical practice guidelines strongly recommend that PCI patients should universally undergo preprocedural assessment for the risk of CI-AKI, and the contrast volume (CV) should be minimized to an achievable level, particularly among the high AKI risk patients. However, data on the CV use based on the comprehensive preprocedural risk assessment is still lacking.
Purpose
Our study aimed to 1) assess the impact of CV increase with the incidence of AKI among high AKI risk patients, and 2) retrospectively evaluate the used CV based on the preprocedural comprehensive risk assessment for patients undergoing PCI within multicenter longitudinal registry.
Methods
Between 2009 and 2018, 22,373 patients underwent PCI in 14 participating facilities, and consecutive patient data was registered. AKI was defined as a >0.3mg/dl absolute or >1.5-fold relative increase in post-PCI creatinine or new initiation of dialysis, based on the Acute Kidney Injury Network criteria. The post-procedural creatinine was defined as the highest value within 30 days after the indexed procedure. Congruent with the National Cardiovascular Data Registry (NCDR) definition, if more than 1 post-procedural creatinine level was measured, the highest value was used for determining AKI. We divided the patients into four groups according to quartile of NCDR AKI risk scores.
Results
Mean age of the patients were 68.7±11.1 years, and 79.1% were male. Mean CV use was 161.4±74.8ml. The incidence of CI-AKI was 8.9%, and was particularly high among high AKI risk patients (21.1%); CV (per 1ml linear increase) was directly associated with the occurrence of AKI (OR: 1.002 per unit in CV; 95% CI: 1.001–1.003; P<0.001) in these patients. CV during PCI decreased with the progression of chronic kidney disease (CKD), but it did not alter by the overall NCDR AKI risk score (Figure). After multivariable adjustment, CV was predicted by stage of CKD (−13.68ml; 95% CI: −12.05 to −15.30ml; P<0.001), but not by the value of pre-procedure prediction score (NCDR AKI risk score, P=0.575).
CV according to CKD/NCDR AKI risk score
Conclusions
Higher CV was directly associated with the occurrence of AKI among higher AKI risk patients. However, CV use was largely influenced by the stage of renal disease, and not with overall patient risk presented by contemporary risk scores. Our results have identified an important evidence-practice gap and emphasizes the importance of total preprocedural assessment to minimize CV and prevent subsequent AKI.
Acknowledgement/Funding
KAKENHI (16KK0186, 16H05215, 25460630, 25460777), Bayer, Daiichi Sankyo, Bristol-Myers Squibb, Teikoku Seiyaku, Sumitomo Dainippon, AstraZeneka, Pfizer
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Affiliation(s)
- S Shoji
- Keio University School of Medicine, Cardiology, Tokyo, Japan
| | - M Sawano
- Keio University School of Medicine, Cardiology, Tokyo, Japan
| | - Y Shiraishi
- Keio University School of Medicine, Cardiology, Tokyo, Japan
| | - N Ikemura
- Keio University School of Medicine, Cardiology, Tokyo, Japan
| | - S Noma
- Saiseikai Utsunomiya Hospital, Cardiology, Tochigi, Japan
| | - M Suzuki
- National Hospital Organization Saitama National Hospital, Cardiology, Saitama, Japan
| | - Y Numasawa
- Japanese Red Cross Ashikaga Hospital, Cardiology, Tochigi, Japan
| | - K Fukuda
- Keio University School of Medicine, Cardiology, Tokyo, Japan
| | - S Kohsaka
- Keio University School of Medicine, Cardiology, Tokyo, Japan
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5
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Fukuoka R, Kohno T, Kohsaka S, Shiraishi Y, Sawano M, Abe T, Nagatomo Y, Goda A, Mizuno A, Fukuda K, Shadman R, Dardas TF, Levy WC, Yoshikawa T. P5667Predicting sudden cardiac death in Japanese heart failure patients: International validation of the Seattle Proportional Risk Model. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- R Fukuoka
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - T Kohno
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - S Kohsaka
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - Y Shiraishi
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - M Sawano
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - T Abe
- Keio University School of Medicine, Department of Preventive Medicine and Public Health, Tokyo, Japan
| | - Y Nagatomo
- Sakakibara Heart Institute, Department of Cardiology, Tokyo, Japan
| | - A Goda
- Kyorin University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - A Mizuno
- St. Luke's International Hospital, Department of Cardiology, Tokyo, Japan
| | - K Fukuda
- Keio University School of Medicine, Department of Cardiology, Tokyo, Japan
| | - R Shadman
- Southern California Permanente Medical Group, Los Angeles, United States of America
| | - T F Dardas
- University of Washington, Seattle, United States of America
| | - W C Levy
- University of Washington, Seattle, United States of America
| | - T Yoshikawa
- Sakakibara Heart Institute, Department of Cardiology, Tokyo, Japan
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6
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Hiraide T, Sawano M, Ueda I, Numasawa Y, Noma S, Suzuki M, Yuasa S, Hayashida K, Maekawa Y, Miyata H, Kohsaka S, Fukuda K. P4282Incidence and Predictors of Iatrogenic Coronary Artery Dissection in Contemporary Percutaneous Coronary Intervention: A Report from a Multicenter PCI Registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kimura M, Kohno T, Kohsaka S, Ueda I, Sawano M, Nakagawa S, Ohki T, Matsubara T, Noma S, Hayashida K, Yuasa S, Maekawa Y, Fukuda K. P4283The impact of left ventricular dysfunction on in-hospital complications and 1-year prognosis in patients undergoing percutaneous coronary intervention in Japan: a report from KiCS-PCI-Registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Shoji S, Kohsaka S, Ueda I, Sawano M, Ikemura N, Katsuki T, Hiraide T, Maekawa Y, Yuasa S, Hayashida K, Noma S, Suzuki M, Numasawa Y, Miyata H, Fukuda K. 2033Incidence and predictors of stroke after percutaneous coronary intervention in the era of transradial intervention. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.2033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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9
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Kao R, Rajagopalan A, Beckett A, Beckett A, Rex R, Shah S, Waddell J, Boitano M, Faidi S, Babatunde O, Lawson F, Grant A, Sudarshan M, Sudarshan M, Takashashi M, Waggott M, Lampron J, Post A, Beale E, Bobrovitz N, Zakrison T, Smith A, Bawazeer M, Evans C, Leeper T, Kagedan D, Grenier T, Rezendo-Neto J, Roberts D, Roberts D, Stark P, Berg R, Mehta S, Gardner P, Moore L, Vassilyadi M, Moore L, Moore L, Hoshizaki B, Rezende-Neto J, Slaba I, Ramesh A, Grigorovich A, Parry N, Pajak C, Rosenbloom B, Grunfeld A, van Heest R, Fernandes J, Doucet J, Schooler S, Ali J, Klassen B, Santana M, McFarlan A, Ball C, Blackmore C, Rezende-Neto J, Kidane B, Hicks C, Brennan M, Brennan M, Harrington A, Sorvari A, Stewart TC, Biegler N, Chaubey V, Tsang B, Benjamin S, Hogan A, Fraser J, Martin M, Bridge J, Faidi S, Waligora M, Hsiao M, Sharma S, Sankarankutty A, Mckee J, Mckee J, Mckee J, Snider C, Szpakowski J, Brown R, Shah S, Shiu M, Chen M, Bell N, Besserer F, Bell N, Trudeau MO, Alhabboubi M, Rezende-Neto J, Rizoli S, Hill A, Joseph B, Lawless B, Jiao X, Xenocostas A, Rui T, Parry N, Driman D, Martin C, Stewart TC, Walsh J, Parry N, Merritt N, Elster E, Tien H, Phillips L, Bratu I, Nascimento B, Pinto R, Callum J, Tien H, Rizoli S, McMullan J, McGlasson R, Mahomed N, Flannery J, Bir C, Baillie F, Coates A, Asiri S, Foster P, Baillie F, Bhandari M, Phillips L, Bratu I, Schuurman N, Oliver L, Nathens A, Yazdani A, Alhabboubi M, St. Louis E, Tan X, Fata P, Deckelbaum D, Chughtai T, Razek T, Khwaja K, St. Louis E, Alhabboubi M, Tan X, Fata P, Deckelbaum D, Chughtai T, Razek T, Khwaja K, Takada M, Sawano M, Ito H, Tsutsumi H, Keenan A, Waggott M, Hoshizaki B, Brien S, Gilchrist M, Janis J, Phelan H, Minei J, Santana M, Stelfox H, McCredie V, Leung E, Garcia G, Rizoli S, Nathens A, Dixon E, Niven D, Kirkpatrick A, Feliciano D, D’Amours S, Ball C, Ahmed N, Izadi H, McFarlan A, Nathens A, Pavenski K, Nathens A, Bridge J, Tallon J, Leeper W, Vogt K, Stewart TC, Gray D, Parry N, Ameer A, Alhabboubi M, Alzaid S, Deckelbaum D, Fata P, Khwaja K, Razek T, Deckelbaum D, Drudi L, Boulva K, Rodrigue N, Khwaja K, Chughtai T, Fata P, Razek T, Rizoli S, Carreiro P, Lisboa T, Winter P, Ribeiro E, Cunha-Melo J, Andrade M, Zygun D, Grendar J, Ball C, Robertson H, Ouellet JF, Cheatham M, Kirkpatrick A, Ball C, Ouellet JF, McBeth P, Kirkpatrick A, Dixon E, Groff P, Inaba K, Okoye O, Pasley J, Demetriades D, Al-Harthi F, Cheng A, Lalani A, Mikrogianakis A, Cayne S, Knittel-Keren D, Gomez M, Stelfox H, Turgeon A, Lapointe J, Bourgeois G, Karton C, Rousseau P, Hoshizaki B, Stelfox H, Turgeon A, Bourgeois G, Lapointe J, Stelfox H, Turgeon A, Bourgeois G, Lapointe J, Rousseau P, Braga B, Faleiro R, Magaldi M, Cardoso G, Lozada W, Duarte L, Rizoli S, Ball C, Oddone-Paolucci E, Doig C, Kortbeek J, Gomez M, Fish J, Leach L, Leelapattana P, Fleming J, Bailey C, Nolan B, DeMestral C, McFarlan A, Zakirova R, Nathens A, Dabbs J, Duff D, Michalak A, Mitchell L, Nathens A, Singh M, Topolovec-Vranic J, Tymianski D, Yetman L, Canzian S, MacPhail I, Constable L, van Heest R, Tam A, Mahadevan P, Kim D, Bansal V, Casola G, Coimbra R, Gladwin C, Misra M, Kumar S, Gautam S, Sorvari A, Blackwood B, Coates A, Baillie F, Stelfox H, Nathens A, Wong C, Straus S, Haas B, Lenartowicz M, Parkovnick M, Parry N, Inaba K, Dixon E, Salim A, Pasley J, Kirkpatrick A, Ouellet JF, Niven D, Kirkpatrick A, Ball C, Neto C, Nogueira G, Fernandes M, Almeida T, de Abreu EMS, Rizoli S, Abrantes W, Taranto V, Parry N, Forbes T, Knight H, Keenan A, Yoxon H, Macpherson A, Bridge J, Topolovec-Vranic J, Mauceri J, Butorac E, Ahmed N, Holmes J, Gilliland J, Healy M, Tanner D, Polgar D, Fraser D, McBeth P, Crawford I, Tiruta C, Ball C, Kirkpatrick A, Roberts D, Ferri M, Bobrovitz N, Khandwala F, Stelfox H, Widder S, Mckee J, Hogan A, Benjamin S, Atkinson P, Benjamin S, Watson I, Hogan A, Benjamin S, Woodford S, Jaramillo DG, Nathens A, Alonazi N, Coates A, Baillie F, Zhang C, McFarlan A, Sorvari A, Chalklin K, Canzian S, Nathens A, DeMestral C, Hill A, Langer J, Nascimento B, Alababtain I, Fung SY, Passos E, Luz L, Brnjac E, Pinto R, Rizoli S, Widder S, Widder S, Widder S, Nathens A, Van Heest R, Constable L, Mancini F, Heidary B, Bell N, Appleton L, Hennecke P, Taunton J, Khwaja K, O’Connor M, Hameed M, Garraway N, Simons R, Evans D, Taulu T, Quinn L, Kuipers D, Rizoli S, Rogers C, Geerts W, Rhind S, Rizoli S, George K, Quinn L, Babcock C, Hameed M, Simons R, Caron N, Hameed M, Simons R, Prévost F, Razek T, Khwaja K, Sudarshan M, Razek T, Fata P, Deckelbaum D, Khwaja K, de Abreu EMS, Neto C, Almeida T, Pastore M, Taranto V, Fernandes M, Rizoli S, Nascimento B, Sankarankutty A, Pinto R, Callum J, Tremblay L, Tien H, Fowler R, Pinto R, Nathens A, Sadoun M, Harris J, Friese R, Kulvantunyou N, O’Keeffe T, Wynne J, Tang A, Green D, Rhee P, Trpkovski J, Blount V. Trauma Association of Canada Annual Scientific Meeting abstractsErythroopoietin resuscitated with normal saline, Ringer’s lactate and 7.5% hypertonic saline reduces small intestine injury in a hemorrhagic shock and resuscitation rat model.Analgesia in the management of pediatric trauma in the resuscitative phase: the role of the trauma centre.Multidisciplinary trauma team care in Kandahar, Afghanistan: current injury patterns and care practices.Does computed tomography for penetrating renal injury reduce renal exploration? An 8-year review at a Canadian level 1 trauma centre.The other side of pediatric trauma: violence and intent injury.Upregulation of activated protein C leads to factor V deficiency in early trauma coagulopathy.A provincial integrated model of improved care for patients following hip fracture.Sports concussion: an Olympic boxing model comparing sex with biomechanics and traumatic brain injury.A multifaceted quality improvement strategy to optimize monitoring and management of delirium in trauma patients: results of a clinician survey.Risk factors for severe all-terrain vehicle injuries in Alberta.Evaluating potential spatial access to trauma centre care by severely injured patients.Incidence of brain injury in facial fractures.Surgical outcomes and the acute care surgery service.The acute care general surgery population and prognostic factors for morbidity and mortality.Disaster preparedness of trauma.What would you like to know and how can we help you? Assessing the needs of regional trauma centres.Posttraumatic stress disorder screening for trauma patients at a level 1 trauma centre.Physical and finite element model reconstruction of a subdural hematoma event.Abdominal wall reconstruction in the trauma patient with an open abdomen.Development and pilot testing of a survey to measure patient and family experiences with injury care.Occult shock in trauma: What are Canadian traumatologists missing?Timeliness in obtaining emergent percutaneous procedures for the severely injured patient: How long is too long?97% of massive transfusion protocol activations do not include a complete hemorrhage panel.Trauma systems in Canada: What system components facilitate access to definitive care?The role of trauma team leaders in missed injuries: Does specialty matter?The adverse consequences of dabigatran among trauma and acute surgical patients.A descriptive study of bicycle helmet use in Montréal.Factor XIII, desmopressin and permissive hypotension enhance clot formation compared with normotensive resuscitation: uncontrolled hemorrhagic shock model.Negative pressure wound therapy for critically ill adults with open abdominal wounds: a systematic review.The “weekend warrior:” Fact or fiction for major trauma?Canadian injury preventon curriculum: a means to promote injury prevention.Penetrating splenic trauma: Safe for nonoperative management?The pediatric advanced trauma life support course: a national initiative.The effectiveness of a psycho-educational program among outpatients with burns or complex trauma.Trauma centre performance indicators for nonfatal outcomes: a scoping review.The evaluation of short track speed skating helmet performance.Complication rates as a trauma care performance indicator: a systematic review.Unplanned readmission following admission for traumatic injury: When, where and why?Reconstructions of concussive impacts in ice hockey.How does head CT correlate with ICP monitoring and impact monitoring discontinuation in trauma patients with a Marshall CT score of I–II?Impact of massive transfusion protocol and exclusion of plasma products from female donors on outcome of trauma patients in Calgary region of Alberta Health Services.Primary impact arthrodesis for a neglected open Weber B ankle fracture dislocation.Impact of depression on neuropsychological functioning in electrical injury patients.Predicting the need for tracheostomy in patients with cervical spinal cord injury.Predicting crumping during computed tomography imaging using base deficit.Feasibility of using telehomecare technology to support patients with an acquired brain injury and family care-givers.Program changes impact the outcomes of severely injured patients.Do trauma performance indicators accurately reflect changes in a maturing trauma program?One-stop falls prevention information for clinicians: a multidisciplinary interactive algorithm for the prevention of falls in older adults.Use of focused assessment with sonography for trauma (FAST) for combat casualties in forward facilities.Alberta All-terrain Vehicle Working Group: a call to action.Observations and potential role for the rural trauma team development course (RTTDC) in India.An electronic strategy to facilitate information-sharing among trauma team leaders.Development of quality indicators of trauma care by a consensus panel.An evaluation of a proactive geriatric trauma consultation service.Celebrity injury-related deaths: Is a gangster rapper really gangsta?Prevention of delirium in trauma patients: Are we giving thiamine prophylaxis a fair chance?Intra-abdominal injury in patients who sustain more than one gunshot wound to the abdomen: Should non-operative management be used?Retrospective review of blunt thoracic aortic injury management according to current treatment recommendations.Telemedicine for trauma resuscitation: developing a regional system to improve access to expert trauma care in Ontario.Comparing trauma quality indicator data between a pediatric and an adult trauma hospital.Using local injury data to influence injury prevention priorities.Systems saving lives: a structured review of pediatric trauma systems.What do students think of the St. Michael’s Hospital ThinkFirst Injury Prevention Strategy for Youth?An evidence-based method for targeting a shaken baby syndrome prevention media campaign.The virtual mentor: cost-effective, nurse-practitioner performed, telementored lung sonography with remote physician guidance.Quality indicators used by teaching versus nonteaching international trauma centres.Compliance to advanced trauma life support protocols in adult trauma patients in the acute setting.Closing the quality improvement loop: a collaborative approach.National Trauma Registry: “collecting” it all in New Brunswick.Does delay to initial reduction attempt affect success rates for anterior shoulder dislocation (pilot study)?Use of multidisciplinary, multi-site morbidity and mortality rounds in a provincial trauma system.Caring about trauma care: public awareness, knowledge and perceptions.Assessing the quality of admission dictation at a level 1 trauma centre.Trauma trends in older adults: a decade in review.Blunt splenic injury in patients with hereditary spherocytosis: a population-based analysis.Analysis of trauma team activation in severe head injury: an institutional experience.ROTEM results correlate with fresh frozen plasma transfusion in trauma patients.10-year trend of assault in Alberta.10-year trend in alcohol use in major trauma in Alberta.10-year trend in major trauma injury related to motorcycles compared with all-terrain vehicles in Alberta.Referral to a community program for youth injured by violence: a feasibility study.New impaired driving laws impact on the trauma population at level 1 and 3 trauma centres in British Columbia, Canada.A validation study of the mobile medical unit/polyclinic team training for the Vancouver 2010 Winter Games.Inferior vena cava filter use in major trauma: the Sunny-brook experience, 2000–2011.Relevance of cellular microparticles in trauma-induced coagulopathy: a systemic review.Improving quality through trauma centre collaboratives.Predictors of acute stress response in adult polytrauma patients following injury.Patterns of outdoor recreational injury in northern British Columbia.Risk factors for loss-to-follow up among trauma patients include functional, socio-economic, and geographic determinants: Would mandating opt-out consent strategies minimize these risks?Med-evacs and mortality rates for trauma from Inukjuak, Nunavik, Quebec.Review of open abdomens in McGill University Health Centre.Are surgical interventions for trauma associated with the development of posttraumatic retained hemothorax and empyema?A major step in understanding the mechanisms of traumatic coagulopathy: the possible role of thrombin activatable fibrinolysis inhibitor.Access to trauma centre care for patients with major trauma.Repeat head computed tomography in anticoagulated traumatic brain injury patients: still warranted.Improving trauma system governance. Can J Surg 2012. [DOI: 10.1503/cjs.006312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Matsushita T, Kawakubo Y, Sawano M, Funatsu K. Vitronectin enhances adhesion force and t-PA production of weakly adherent 293 cells exposed to a shear stress. Cytotechnology 2011; 32:181-90. [PMID: 19002979 DOI: 10.1023/a:1008140632747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The effects of shear stress on the adhesion andproductivity of 293 cells were studied quantitativelyand compared with those of Vero and human liver cells.These cells were cultured in polystyrene dishes byusing shear stress exposing equipment. 50% of 293cells cultured in 2% FBS supplemented medium detachedfrom the dish after 29 h of exposure to a shear stressof 0.10 Pa. On the other hand, 90% of Vero and humanliver cells remained on the dish under the samecondition. Observations with scanning electronmicroscopy about cell adhesion plaques on the surfaceof the dish showed that the area covered withlamellipodia and the number of microspikes for 293cells were found to be less than those of the othercell lines. Several attachment factors, especiallyvitronectin, were found to enhance the number ofmicrospikes and the adhesion force of 293 cells.Almost 100% of 293 cells remained on thevitronectin-coated dish after 40 h under 0.10 Pa ofshear stress. A higher shear stress (greater than 0.10Pa) caused a decrease in tissue plasminogen activator(t-PA) productivity of 293 cells. But 0.03 Pastimulated the t-PA secretion on the non-coated dish.Vitronectin also enhanced the t-PA secretion evenunder 0.10 Pa. These results indicate that theadhesion force of 293 cells is obviously weaker thanthat of the other cell lines, and vitronectin enhancesthe adhesion force and the productivity of 293 cellsexposed to a shear stress.
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Affiliation(s)
- T Matsushita
- Department of Chemical Systems and Engineering, Graduate School of Engineering, Kyushu University, 6-10-1 Hakozaki, Higashi-ku, Fukuoka, 812-8581, Japan
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Abstract
BACKGROUND We developed a non-invasive, continuous, high-resolution method of measuring carboxyhaemoglobin fraction (COHb%) using expiratory gas analysis (EGA). We assessed whether application of EGA to carboxyhaemoglobin dilution provides red cell volume (RCV) measurement with accuracy equivalent to that of CO-haemoximetry, with a smaller infusion volume of carbon-monoxide-saturated autologous blood (COB). Method. We assessed the agreement between repeated COHb% measurements by EGA and simultaneous measurement by CO-haemoximetry, using Bland and Altman plot, in healthy subjects and patients with artificially controlled ventilation and no radiological evidence of pulmonary oedema or atelectasis. We assessed the agreement between RCV measurements by EGA with infusion of 20 ml of COB (RCVEGA) and RCV measurements by CO-haemoximetry with infusion of 100 ml of COB (RCVHEM), in healthy subjects. RESULTS The 'limits of agreement' between COHb% measurement by EGA (1 min average) and CO-haemoximetry were -0.09 and 0.08% in healthy subjects, and -0.11 and 0.09% in patients. Given the resolution of CO-haemoximetry (0.1%), the accuracy of EGA was equivalent to or greater than that of CO-haemoximetry. The 'limits of agreement' between RCVEGA and RCVHEM were -0.14 and 0.15 litre. Given the average resolution of RCVHEM (0.14 litre), the accuracy of RCVEGA was equivalent to that of RCVHEM. CONCLUSION EGA provided non-invasive, accurate, continuous, high-resolution COHb% measurements. Applying EGA to carboxyhaemoglobin dilution, we achieved RCV measurements with accuracy equivalent to that of CO-haemoximetry, with one-fifth of the COB infusion volume. However, clinical application of the method is limited to patients with no radiological evidence of pulmonary oedema or atelectasis.
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Affiliation(s)
- M Sawano
- Department of Emergency Medicine and Critical Care, Saitama Medical Center, 1981 Tsujido-machi, Kamoda, Kawagoe-shi, Saitama 350-8550, Japan.
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Watanabe Y, Sunayama S, Shimada K, Sawano M, Hoshi S, Iwama Y, Mokuno H, Daida H, Yamaguchi H. Troglitazone improves endothelial dysfunction in patients with insulin resistance. J Atheroscler Thromb 2001; 7:159-63. [PMID: 11480457 DOI: 10.5551/jat1994.7.159] [Citation(s) in RCA: 46] [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: 11/11/2022] Open
Abstract
Insulin resistance is a possible major metabolic cause of atherosclerosis. Endothelial dysfunction is commonly found in patients with insulin resistance, and primary treatment of insulin resistance with troglitazone should improve such endothelial dysfunction. Thus, the effects of troglitazone on endothelial function were investigated. Thirteen non-diabetic male subjects with hyperinsulinemic response to oral glucose load (n = 7) and normal (n = 6) subjects were investigated. Flow-mediated dilatation (FMD) of the brachial artery was examined by high resolution ultrasonography before and after the administration of troglitazone of 400 mg for 4 weeks. In insulin resistant subjects, fasting glucose (4.9+/-0.3 to 4.7+/-0.3 mmol/L, p<0.05), insulin (45+/-30 to 25+/-15 pmol/L, p<0.05) and response to oral glucose load (AUC glucose: 15.0+/-3.5 to 13.0+/-2.2 mmol x h/L, p<0.05; AUC insulin: 965+/-560 to 475+/-275 pmol x h/L, p<0.05) were significantly reduced. FMD was significantly improved in insulin resistant subjects. A significant negative correlation was observed between FMD and AUC insulin (r=-0.64, p<0.05). The present study demonstrates that FMD is impaired in insulin resistant subjects, and troglitazone improves the blunted vascular response and impaired insulin response. This finding suggests that primary treatment of insulin resistance could prevent the development of atherosclerosis by improving endothelial dysfunction.
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Affiliation(s)
- Y Watanabe
- Department of Cardiology, Juntendo University, Tokyo, Japan.
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Sawano M, Watanabe Y, Ohmura H, Shimada K, Daida H, Mokuno H, Yamaguchi H. Potentially protective effects of the Ser447-Ter mutation of the lipoprotein lipase gene against the development of coronary artery disease in Japanese subjects via a beneficial lipid profile. Jpn Circ J 2001; 65:310-4. [PMID: 11316129 DOI: 10.1253/jcj.65.310] [Citation(s) in RCA: 22] [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] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Several DNA variants at the lipoprotein lipase (LPL) gene locus have been found to be associated with the plasma lipid levels and the prevalence of coronary artery disease (CAD). In particular, the Ser447-termination (Ter) mutation at the exon 9 of the LPL gene has the potential to elevate the plasma high-density lipoprotein (HDL) levels, but it remains unknown in the Japanese population. The present study investigated 93 CAD patients and 96 age- and sex-matched healthy controls. The Ser447-Ter mutation was determined by polymerase chain reaction restriction fragment length polymorphism method. The allelic frequency of the Ser447-Ter mutation was 0.103 in all subjects. The Ser447-Ter (GG and CG) group was associated with significantly higher levels of plasma HDL-cholesterol (p<0.001) and lower levels of plasma triglyceride than the CC group (p<0.02). The peak particle size of low-density lipoprotein (LDL) was significantly larger in the Ser447-Ter (GG and CG) group than in CC group (p<0.05). The frequency of the Ser447-Ter genotype in GG and CG was significantly lower in CAD than in the controls (11.9% vs 26%, odds ratio = 0.38; 95% confidence interval, 0.18-0.81; p<0.02). These results suggest that the Ser447-Ter mutation of the LPL gene is associated with high plasma HDL-cholesterol levels, low plasma triglyceride levels and a larger LDL particle size. This mutation may have a protective effect against the development of CAD via its favorable lipoprotein profile.
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Affiliation(s)
- M Sawano
- Department of Cardiology, Juntendo University, Tokyo, Japan.
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Shimada K, Daida H, Mokuno H, Watanabe Y, Sawano M, Iwama Y, Seki E, Kurata T, Sato H, Ohashi S, Suzuki H, Miyauchi K, Takaya J, Sakurai H, Yamaguchi H. Association of seropositivity for antibody to Chlamydia-specific lipopolysaccharide and coronary artery disease in Japanese men. Jpn Circ J 2001; 65:182-7. [PMID: 11266192 DOI: 10.1253/jcj.65.182] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Recent studies suggest an association between Chlamydia pneumoniae infection and coronary artery disease (CAD). To examine this relationship in Japanese men, serum IgA and IgG antibodies to Chlamydia-specific lipopolysaccharide were measured by enzyme-linked immunosorbent assay in 507 patients with CAD and 200 age-matched controls. CAD patients were divided into (1) 269 patients with myocardial infarction (MI) and (2) 238 patients with chronic coronary heart disease (CCHD). Compared with the control group, the CAD group did not differ in the prevalences of both antibodies (IgA: 23.7 vs 18.0%, p=0.10; IgG: 52.7 vs 51.0%, p=0.6). The index of IgG antibody was not significantly different between CAD and control groups (median 1.19 vs 1.18, p=0.3), whereas the index of IgA antibody was significantly higher in CAD than control group (median 0.60 vs 0.46, p<0.0001). Compared with the control group, the MI group had a significantly higher prevalence of IgA antibody (28.6 vs 18.0%, p=0.007); however, there was no difference in the prevalence of IgG antibody (58.0 vs 51.0%, p=0.13). The CCHD group did not differ in the prevalences of both antibodies (IgA: 18.1 vs 18.0%, p=0.9; IgG: 45.6 vs 51.0%, p=0.2). After the adjustment for coronary risk factors, odds ratios (ORs) of seropositive antibodies for CAD were 1.59 [95% confidence interval (CI): 0.88-2.87, p=0.12] for IgA seropositivity and 0.92 (95%CI: 0.58-1.47, p=0.7) for IgG seropositivity in all cases. In the MI and control groups, ORs of seropositive antibodies for MI were 2.67 (95%CI: 1.32-5.38, p=0.007) for IgA seropositivity, and 1.36 (95%CI: 0.79-2.36, p=0.2) for IgG seropositivity. This study discovered that IgA antibody to Chlamydia was significantly associated with CAD, especially with MI, in Japanese Men and the findings suggest that chronic infection of Chlamydia may be linked to the pathogenesis of MI.
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Affiliation(s)
- K Shimada
- Department of Cardiology, Juntendo University, School of Medicine, Tokyo, Japan.
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Abstract
During admission for investigation of dysphagia, an 82-year-old woman suddenly complained of dyspnea, which was followed by cardiogenic shock. Her symptoms, electrocardiogram, echocardiogram and laboratory data were compatible with an extensive acute anterior myocardial infarction. Emergency cardiac catheterization showed no atheromatous narrowing in any coronary artery. However, the contractions of the left and right ventricles were diffusely and severely impaired, except for some hyperkinesis of the basal area. The asynergy, as well as the abnormalities on the ECG, improved almost to normal by the 35th hospital day. An endomyocardial biopsy from the right ventricle during the acute phase showed atypical myocardial damage with proliferation of fine collagen fibers and small round-cell infiltration including polymorphologic leukocytes. This type of transient cardiac disorder has recently been described in Japan, and is called 'Tako-tsubo cardiomyopathy' because of the characteristic appearance of the left ventricular asynergy. In the present case, ventricular asynergy was not limited to the left ventricle, but was also present in the right ventricle.
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Affiliation(s)
- N Nyui
- Department of Cardiology, International Goodwill Hospital, Yokohama
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Abstract
Although regulation of the dynamics of plant microtubules (MTs) by microtubule-associated proteins (MAPs) has been suggested, the mechanism has not yet been elucidated. As one candidate, a MAP composed of a 65 kDa polypeptide (65 kDa MAP) has been isolated from tobacco cultured cells [Jiang and Sonobe (1993), J. Cell Sci 105: 8911. To investigate the physiological role of the 65 kDa MAP in situ, we analyzed the changes in content and colocalization of this MAP with cortical MTs in relation to elongation growth, using azuki bean epicotyls (Vigna angularis Ohwi et Ohashi). All apical, intermediate, and basal segments prepared from 6 d seedlings showed high growth activity. In 12 d seedlings, growth activity of intermediate and basal segments was low, although that of apical segments was high. The relationship between the growth activity and the orientation of cortical MTs in the epidermal cells was analyzed. Cells could be classified into four types with respect to orientation of cortical MTs: transverse (T), oblique (O), longitudinal (L) to the vertical axis of cells, and random (R). In rapidly growing segments, three types of cells, T, O, L, were observed at similar ratios. In such segments, significant amounts of the 65 kDa MAP were expressed, and it colocalized well with cortical MTs. In segments showing low growth activity, most of the cells showed oblique and longitudinal orientation of cortical MTs. In such segments, the content of the 65 kDa MAP was low. These results suggested involvement of this 65 kDa MAP in regulation of the elongation growth of this epicotyl.
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Affiliation(s)
- M Sawano
- Department of Life Science, Faculty of Science, Himeji Institute of Technology, Harima Science Park City, Hyogo, Japan
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Shimada K, Mokuno H, Watanabe Y, Sawano M, Daida H, Yamaguchi H. High prevalence of seropositivity for antibodies to Chlamydia-specific lipopolysaccharide in patients with acute coronary syndrome. J Cardiovasc Risk 2000; 7:209-13. [PMID: 11006891 DOI: 10.1177/204748730000700308] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Results of recent studies have demonstrated that there is an association between infection with Chlamydia pneumoniae and coronary artery disease (CAD). Inflammatory response caused by chlamydial infection has been considered to contribute to the development of atherosclerosis in coronary arteries. OBJECTIVE The aim of this study was to investigate the specific relations between chlamydial infection and coronary events in patients with CAD. METHODS We measured serum levels of immunoglobulin A and G antibodies against Chlamydia spp.-specific lipopolysaccharide in 155 patients with CAD and 60 age-matched and sex-matched healthy controls by enzyme-linked immunosorbent assay. CAD patients were divided into groups of the patients with acute coronary syndrome [(ACS), n = 35], old myocardial infarction [(OMI), n = 60] and chronic coronary heart disease [(CCHD), n = 60]. RESULTS Prevalence of both seropositive antibodies in the control group and CCHD group were not different. In contrast, in ACS group there were significantly higher prevalences of seropositive immunoglobulin A (46 versus 12%, P = 0.0001) and G (74 versus 45%, P = 0.005) antibodies and in OMI group there was a significantly higher prevalence of seropositive immunoglobulin A antibodies (28 versus 12%, P = 0.02). Furthermore, compared with CCHD group, in ACS group there were significantly higher prevalences of seropositive immunoglobulin A (P = 0.00006) and G (P = 0.002) antibodies and in OMI group there was a higher prevalence of seropositive immunoglobulin A (P = 0.01). Adjustment for confounding factors did not change these findings. CONCLUSIONS Infection with Chlamydia is significantly associated with ACS and OMI, but not with CCHD. These findings suggest that chronic and reactive infection with Chlamydia can lead to disruption of vulnerable plaque in patients with ACS.
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Affiliation(s)
- K Shimada
- Department of Cardiology, School of Medicine, Juntendo University, Tokyo, Japan.
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Shimada K, Mokuno H, Watanabe Y, Sawano M, Sato H, Kurata T, Nakamura T, Daida H, Yamaguchi H. [Association between chlamydial infection and coronary artery disease]. J Cardiol 1999; 34:259-65. [PMID: 10579134] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Recent epidemiological studies have demonstrated the association between Chlamydia pneumoniae infection and coronary atherosclerosis. However, the relationship is less clear in the Japanese population. Serum IgA and IgG antibodies to Chlamydia-specific lipopolysaccharide were measured by enzyme-linked immunosorbent assay in 152 consecutive patients(112 males, 40 females, mean age 57 years)who underwent coronary angiography. Patients(n = 123)with coronary artery disease(CAD)were defined as having more than 50% diameter stenosis in at least one major coronary artery. The control group(n = 29) had normal coronary angiograms. In the CAD group, there was a high tendency of prevalence of IgA(20% vs 7%, p = 0.08)and IgG(54% vs 34%, p = 0.052). Prevalence of either IgA or IgG was significantly higher (59% vs 38%, p = 0.045) compared with the control group. Although the index of IgA antibody was not significantly different between the CAD and control groups(median 0.52 vs 0.36, p = 0.19), the index of IgG antibody was significantly higher in the CAD group than in the control group(median 1.29 vs 0.82, p = 0.026). The odds ratios for CAD were 3.4[95% confidence interval(CI)0.6-18.7]for the prevalence of IgA, 2.3(95% CI 0.9-5.2)for the prevalence of IgG, and 2.3(95% CI 1.0-5.2)for the prevalence of either IgA or IgG. Patients with CAD tended to have high prevalence of antibodies to Chlamydia spp, and these findings suggest an association between chlamydial infection and coronary atherosclerosis in the Japanese population.
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Affiliation(s)
- K Shimada
- Department of Cardiology, Juntendo University School of Medicine, Tokyo
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Yamagami S, Yamanaka O, Sawano M, Nyui N, Nakayama R. [A 67-year-old man with progressive shortness of breath]. J Cardiol 1999; 34:229-32. [PMID: 10553541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Affiliation(s)
- S Yamagami
- Department of Cardiology, International Goodwill Hospital, Yokohama
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Sunayama S, Watanabe Y, Ohmura H, Sawano M, Shimada K, Mokuno H, Daida H, Yamaguchi H. Effects of troglitazone on atherogenic lipoprotein phenotype in coronary patients with insulin resistance. Atherosclerosis 1999; 146:187-93. [PMID: 10487503 DOI: 10.1016/s0021-9150(99)00138-0] [Citation(s) in RCA: 32] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Insulin resistance is associated with atherogenic lipoprotein phenotype, including small dense LDL particle, hypertriglycemia and low HDL cholesterol levels. Troglitazone, a novel insulin sensitizing agent, may improve the associated lipid profile in patients with insulin resistance. We examined the effects of troglitazone (400 mg daily for 12 weeks) in 12 non-diabetic coronary patients (60+/-10 years), all of whom had hyperinsulinemic response to an oral glucose load. Troglitazone markedly reduced the insulin response. After the treatment, plasma triglycerides decreased by 32% (P<0.05), HDL cholesterol increased by 11%, (P<0.05) and LDL peak particle diameter increased from 24.7+/-0.3 to 25.5+/-0.5 nm (P<0.01). These lipidic improvements were associated with a significant rise in postheparin lipoprotein lipase levels (175+/-52 to 217+/-69 ng/ml, P<0.01). In patients with insulin resistance syndrome, troglitazone improved the atherogenic lipoprotein phenotype as well as hyperinsulinemia. Our data suggest that troglitazone therapy could reduce the atherosclerotic risk due to insulin resistance even in non-diabetic patients.
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Affiliation(s)
- S Sunayama
- Department of Cardiology, Juntendo University, Tokyo, Japan.
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22
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Sunayama S, Watanabe Y, Ohmura H, Sawano M, Ohmura T, Itoh S, Mokuno H, Daida H, Yamaguchi H. Effect of troglitazone in nondiabetic patients with coronary artery disease. J Am Coll Cardiol 1998. [DOI: 10.1016/s0735-1097(98)80388-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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23
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Sawano M. Lipoprotein Lipase Gene Polymorphisms: Associations With Coronary Artery Disease and Lipoprotein Levels in Japanese Population. J Am Coll Cardiol 1998. [DOI: 10.1016/s0735-1097(97)84348-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Sawano M, Watanabe Y, Ohmura H, Shimada K, Mokuno H, Daida H, Yamaguchi H. Lipoprotein lipase gene polymorphisms: associations with coronary artery disease and lipoprotein levels in Japanese population. J Am Coll Cardiol 1998. [DOI: 10.1016/s0735-1097(98)81287-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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25
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Hatsumi C, Watanabe Y, Sawano M, Ohmura H, Mokuno H, Daida H, Yamaguchi H. 1.P.245 The effect of the polymorphism at the 5′ -end of the apolipoprotein A-I gene on high density lipoprotein metabolism and coronary artery disease. Atherosclerosis 1997. [DOI: 10.1016/s0021-9150(97)88425-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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26
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Ohmura H, Watanabe Y, Mokuno H, Sawano M, Hatsumi C, Daida H, Yamaguchi H. 3.P.84 Increased susceptibility of small, dense low-density lipoprotein to oxidation in coronary artery disease. Atherosclerosis 1997. [DOI: 10.1016/s0021-9150(97)89159-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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27
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Jyoujima Y, Kono T, Sawano M, Shimoyama S, Kubota K, Shimada T, Nakahama M, Nakamura T, Ogawa T, Chin H. [A case of resected gastric cancer in which cancer had apparently disappeared by preoperative administration of tegafur]. Gan To Kagaku Ryoho 1994; 21:1275-8. [PMID: 8031172] [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: 01/28/2023]
Abstract
This paper reports a case of gastric carcinoma in which cancerous tissue was not found in the resected specimen, apparently due to preoperative tegafur administration. The patient was a 56-year-old woman who was diagnosed by initial endoscopic examination including endoscopic biopsy as having an advanced gastric cancer of Borrmann type 2. During the waiting period for operation, she was placed on oral administration of tegafur (Futrafur capsule) 600 mg 3 times a day for 31 days. The second endoscopic examination 14 days later showed reduction of both marginal elevation and central excavation of the lesion, and biopsy at this time was negative for carcinoma. Because of the initial definite diagnosis of cancer, a gastric resection was performed 31 days later, but no cancerous tissue was found in the resected specimen. This case was considered to be a carcinoma especially sensitive to tegafur.
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Affiliation(s)
- Y Jyoujima
- Third Dept. of Surgery, Faculty of Medicine, University of Tokyo
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Kai N, Iwasimizu Y, Sato J, Inoue H, Honda Y, Kitagawa T, Miyazaki M, Sawano M, Yamashita M, Kushiro T. Management problems in continuous care of male patients with mild hypertension with special reference to alcohol-intake. J Med Syst 1993; 17:183-6. [PMID: 8254262 DOI: 10.1007/bf00996943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Forty two male patients with borderline and mild hypertension were followed up for 3.9 years without medication. During this period, all subjects had nonpharmacological interventions including salt restriction, weight reduction, anti-smoking or anti-alcohol instruction, and physical exercise after the established protocol. Comparisons of biomedical data between pre- and post-observation revealed no significant improvements. Although the smoking habit decreased during this period, the drinking habit rarely changed and even significant increase of the total amount of alcohol ingestion was observed. These data indicate great limitation of nonpharmacological intervention in the care of these asymptomatic hypertensive patients for a lifelong base.
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Affiliation(s)
- N Kai
- Life Planning Center, Tokyo, Japan
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Ueno Y, Ishii K, Sawano M, Ohtsubo K, Matsuda Y. Toxicological approaches to the metabolites of Fusaria. XI. Trichothecenes and zearalenone from Fusarium species isolated from river sediments. Jpn J Exp Med 1977; 47:177-84. [PMID: 916296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Fifty isolates of Fusarium species from river sediments were examined on their producibility of mycotoxins such as trichothecenes and zearalenone. The most frequent fungal isolate was Fusarium oxysporum, followed by F. solani and F. lateritium. When cultured on Czapek-Dox medium supplemented with peptone, more than half of these strains were suspected to produce trichothecene mycotoxins through toxicity to mice and reticulocyte assay method. One of toxic isolates, F. lateritium 5036, was proved to produce the following five kinds of trichothecenes; diacetoxyscirpenol, 7alpha-hydroxydiacetoxyscirpenol, 7,8alpha-dihydroxy-diacetoxyscirpenol, 8alpha-hydroxydiacetoxyscirpenol (neosolaniol) and diacetylnivalenol. Three strains produced zearalenone on rice grain culture.
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Abstract
Twelve T-2 toxin-producing isolates and four fusarenon-X-producing isolates of Fusarium species were examined for their ability to produce trichothecene mycotoxins in shake culture and jar fermentation. T-2 toxin producers such as Fusarium solani, F. sporotrichiodes, and F. tricinctum produced T-2 toxin and neosolaniol in semisynthetic medium. F. solani M-1-1 produced the largest amount of the mycotoxins in a nutrient medium consisting of 5% glucose (or sucrose), 0.1% peptone, and 0.1% yeast extract in either shake culture or jar fermentation at 24 to 27 C for 5 days. None of the isolates produced significant amount of fusarenon-X in shake cultures.
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Abstract
One hundred sixty-six isolates of Fusarium spp. from domestic cereal grains, feed, and other sources were examined for their ability to produce zearalenone on autoclaved moist rice grains. They belonged to the following species (number of producers/number tested): F. roseum (9/28), F. roseum (Culmorum) (3/4), F. roseum (Gibbosum) (2/5), F. roseum (Avenaceum) (1/2), F. roseum (Scirpi) (0/1), F. tricinctum (1/4), F. tricinctum (Sporotrichiella) (0/7), F. lateritium (1/1), F. episphaeria (0/2), F. moniliforme (0/3), F. oxysporum (0/12), F. rigidiusculum (0/4), F. solani (0/4), F. splendens (0/1), F. nivale (0/2), and Fusarium spp. (15/86). Zearalenone was isolated from molded rice by ethanol extraction and purified by column chromatography. Selected isolates of F. roseum M-3-2 and F. roseum (Gibbosum) A-O-2 produced 50 to 100 mg of zearalenone per kg of rice. Increased yields (250 to 407 mg/kg of rice) were obtained by F. roseum M-3-2 when the substrate was supplemented with 1% peptone.
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