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Nakano M, Yamamoto A, Oka H, Yamazaki O, Jogo A, Kageyama K, Takahashi T, Nishida N, Miki Y. Repeated rough coiling technique of portosystemic shunt: A novel treatment for hepatic encephalopathy. Radiol Case Rep 2024; 19:349-356. [PMID: 38028288 PMCID: PMC10663638 DOI: 10.1016/j.radcr.2023.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 12/01/2023] Open
Abstract
Hepatic encephalopathy (HE) usually occurs in the end stages of cirrhosis. During these stages, portosystemic shunt (PSS) is one cause of severe HE. Previous reports have demonstrated that shunt embolization is effective in cases involving a large PSS. However, embolization is risky in some patients because severe ascites and esophageal varices may result from aggravation of portal hypertension. Herein, we report a case in which intentional flow reduction was repeatedly performed for spleno-renal shunt using 2 flow reduction methods, debranching and the rough coiling technique, for a patient with severe HE for whom embolization of the whole PSS pathway was risky. Complete embolization was finally achieved by repeated flow reduction over 5 sessions. The patient tolerated treatment well with no ascites for 4 years after total embolization. If embolization of the whole PSS puts the patient at risk for refractory HE, repeatable flow reduction might provide a good alternative path to single-step embolization.
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Affiliation(s)
- Mariko Nakano
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Akira Yamamoto
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
- Department of Radiology, Housenka Hospital, Osaka, Japan
| | - Hiroko Oka
- Department of Gastroenterology, Housenka Hospital, Osaka, Japan
| | | | - Atsushi Jogo
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Ken Kageyama
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | | | - Norifumi Nishida
- Department of Radiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
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Pas M, Jogo A, Yamamoto A, Nishida N, Jogo E, Kageyama K, Sohgawa E, Miki Y. Successful treatment of rectal varices with antegrade transvenous sclerotherapy via the splenorenal shunt from the transjugular approach. Radiol Case Rep 2022; 17:4679-4684. [PMID: 36204409 PMCID: PMC9530408 DOI: 10.1016/j.radcr.2022.08.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 08/25/2022] [Indexed: 02/07/2023] Open
Abstract
A 74-year-old patient presented with hematochezia and a history of liver cirrhosis with repeated bleeding from esophageal and rectal varices. Endoscopic examination revealed multiple rectal varices with positive red color signs. Ascites, severe portosystemic thrombosis and a splenorenal shunt were diagnosed on a contrast-enhanced dynamic computed tomography examination. From a transjugular approach, we circumvented thrombosed regions by maneuvering double balloon catheters through the shunt and dilated left colic marginal vein. We managed to successfully obliterate the varices.
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3
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Rimini M, Rimassa L, Ueshima K, Burgio V, Shigeo S, Tada T, Suda G, Yoo C, Cheon J, Pinato DJ, Lonardi S, Scartozzi M, Iavarone M, Di Costanzo GG, Marra F, Soldà C, Tamburini E, Piscaglia F, Masi G, Cabibbo G, Foschi FG, Silletta M, Pressiani T, Nishida N, Iwamoto H, Sakamoto N, Ryoo BY, Chon HJ, Claudia F, Niizeki T, Sho T, Kang B, D'Alessio A, Kumada T, Hiraoka A, Hirooka M, Kariyama K, Tani J, Atsukawa M, Takaguchi K, Itobayashi E, Fukunishi S, Tsuji K, Ishikawa T, Tajiri K, Ochi H, Yasuda S, Toyoda H, Ogawa C, Nishimur T, Hatanaka T, Kakizaki S, Shimada N, Kawata K, Tanaka T, Ohama H, Nouso K, Morishita A, Tsutsui A, Nagano T, Itokawa N, Okubo T, Arai T, Imai M, Naganuma A, Koizumi Y, Nakamura S, Joko K, Iijima H, Hiasa Y, Pedica F, De Cobelli F, Ratti F, Aldrighetti L, Kudo M, Cascinu S, Casadei-Gardini A. Atezolizumab plus bevacizumab versus lenvatinib or sorafenib in non-viral unresectable hepatocellular carcinoma: an international propensity score matching analysis. ESMO Open 2022; 7:100591. [PMID: 36208496 PMCID: PMC9808460 DOI: 10.1016/j.esmoop.2022.100591] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/21/2022] [Accepted: 08/22/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND A growing body of evidence suggests that non-viral hepatocellular carcinoma (HCC) might benefit less from immunotherapy. MATERIALS AND METHODS We carried out a retrospective analysis of prospectively collected data from consecutive patients with non-viral advanced HCC, treated with atezolizumab plus bevacizumab, lenvatinib, or sorafenib, in 36 centers in 4 countries (Italy, Japan, Republic of Korea, and UK). The primary endpoint was overall survival (OS) with atezolizumab plus bevacizumab versus lenvatinib. Secondary endpoints were progression-free survival (PFS) with atezolizumab plus bevacizumab versus lenvatinib, and OS and PFS with atezolizumab plus bevacizumab versus sorafenib. For the primary and secondary endpoints, we carried out the analysis on the whole population first, and then we divided the cohort into two groups: non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) population and non-NAFLD/NASH population. RESULTS One hundred and ninety patients received atezolizumab plus bevacizumab, 569 patients received lenvatinib, and 210 patients received sorafenib. In the whole population, multivariate analysis showed that treatment with lenvatinib was associated with a longer OS [hazard ratio (HR) 0.65; 95% confidence interval (CI) 0.44-0.95; P = 0.0268] and PFS (HR 0.67; 95% CI 0.51-0.86; P = 0.002) compared to atezolizumab plus bevacizumab. In the NAFLD/NASH population, multivariate analysis confirmed that lenvatinib treatment was associated with a longer OS (HR 0.46; 95% CI 0.26-0.84; P = 0.0110) and PFS (HR 0.55; 95% CI 0.38-0.82; P = 0.031) compared to atezolizumab plus bevacizumab. In the subgroup of non-NAFLD/NASH patients, no difference in OS or PFS was observed between patients treated with lenvatinib and those treated with atezolizumab plus bevacizumab. All these results were confirmed following propensity score matching analysis. By comparing patients receiving atezolizumab plus bevacizumab versus sorafenib, no statistically significant difference in survival was observed. CONCLUSIONS The present analysis conducted on a large number of advanced non-viral HCC patients showed for the first time that treatment with lenvatinib is associated with a significant survival benefit compared to atezolizumab plus bevacizumab, in particular in patients with NAFLD/NASH-related HCC.
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Affiliation(s)
- M Rimini
- IRCCS San Raffaele Scientific Institute Hospital, Department of Oncology, Vita-Salute San Raffaele University, Milan, Italy
| | - L Rimassa
- Department of Biomedical Sciences, Humanitas University, Milan, Italy; Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - K Ueshima
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan
| | - V Burgio
- IRCCS San Raffaele Scientific Institute Hospital, Department of Oncology, Vita-Salute San Raffaele University, Milan, Italy
| | - S Shigeo
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - T Tada
- Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan
| | - G Suda
- Department of Gastroenterology and Hepatology, Hokkaido, Japan; University Graduate School of Medicine, Sapporo, Japan
| | - C Yoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - J Cheon
- Department of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - D J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - S Lonardi
- Oncology Unit 3, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - M Scartozzi
- Medical Oncology, University and University Hospital of Cagliari, Cagliari, Italy
| | - M Iavarone
- Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
| | | | - F Marra
- Dipartimento di Medicina Sperimentale e Clinica, Università di Firenze, Firenze, Italy
| | - C Soldà
- Oncology Unit 1, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - E Tamburini
- Department of Oncology and Palliative Care, Cardinale Hospital, Naples, Italy
| | - F Piscaglia
- Division of Internal Medicine, Hepatobiliary and Immunoallergic Disease, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - G Masi
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy; Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy
| | - G Cabibbo
- Section of Gastroenterology & Hepatology, Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, Palermo, Italy
| | - F G Foschi
- Internal Medicine, Infermi Hospital, Faenza (AUSL ROMAGNA), Ravenna, Italy
| | - M Silletta
- Division of Medical Oncology, Policlinico Universitario Campus Bio-Medico, Rome, Italy
| | - T Pressiani
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy
| | - N Nishida
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan
| | - H Iwamoto
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - N Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido, Japan; University Graduate School of Medicine, Sapporo, Japan
| | - B-Y Ryoo
- Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - H J Chon
- Department of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - F Claudia
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - T Niizeki
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - T Sho
- Department of Gastroenterology and Hepatology, Hokkaido, Japan; University Graduate School of Medicine, Sapporo, Japan
| | - B Kang
- Department of Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Republic of Korea
| | - A D'Alessio
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, UK; Department of Translational Medicine, Università degli Studi del Piemonte Orientale, Novara, Italy
| | - T Kumada
- Department of Nursing, Gifu Kyoritsu University, Ogaki, Japan
| | - A Hiraoka
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - M Hirooka
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - K Kariyama
- Department of Gastroenterology, Okayama City Hospital, Okayama, Japan
| | - J Tani
- Department of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan
| | - M Atsukawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - K Takaguchi
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - E Itobayashi
- Department of Gastroenterology, Asahi General Hospital, Asahi, Japan
| | - S Fukunishi
- Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Shinya Fukunishi, Osaka, Japan
| | - K Tsuji
- Center of Gastroenterology, Teine Keijinkai Hospital, Sapporo, Japan
| | - T Ishikawa
- Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan
| | - K Tajiri
- Department of Gastroenterology, Toyama University Hospital, Toyama, Japan
| | - H Ochi
- Hepato-biliary Center, Japanese Red Cross Matsuyama Hospital, Matsuyama, Japan
| | - S Yasuda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - H Toyoda
- Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan
| | - C Ogawa
- Department of Gastroenterology, Japanese Red Cross Takamatsu Hospital, Takamatsu, Japan
| | - T Nishimur
- Department of Internal medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - T Hatanaka
- Department of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi, Japan
| | - S Kakizaki
- Department of Clinical Research, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan
| | - N Shimada
- Division of Gastroenterology and Hepatology, Otakanomori Hospital, Kashiwa, Japan
| | - K Kawata
- Department of Hepatology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - T Tanaka
- Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan
| | - H Ohama
- Premier Departmental Research of Medicine, Osaka Medical and Pharmaceutical University, Shinya Fukunishi, Osaka, Japan
| | - K Nouso
- Department of Gastroenterology, Okayama City Hospital, Okayama, Japan
| | - A Morishita
- Department of Gastroenterology and Hepatology, Kagawa University, Kagawa, Japan
| | - A Tsutsui
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - T Nagano
- Department of Hepatology, Kagawa Prefectural Central Hospital, Takamatsu, Japan
| | - N Itokawa
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - T Okubo
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - T Arai
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan
| | - M Imai
- Department of Gastroenterology, Saiseikai Niigata Hospital, Niigata, Japan
| | - A Naganuma
- Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, Takasaki, Japan
| | - Y Koizumi
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - S Nakamura
- Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan
| | - K Joko
- Hepato-biliary Center, Japanese Red Cross Matsuyama Hospital, Matsuyama, Japan
| | - H Iijima
- Department of Internal medicine, Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Y Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Ehime, Japan
| | - F Pedica
- Department of Experimental Oncology, Pathology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - F De Cobelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy
| | - F Ratti
- Hepatobiliary Surgery Division, Liver Center, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - L Aldrighetti
- Hepatobiliary Surgery Division, Liver Center, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - M Kudo
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Higashi-Osaka, Japan
| | - S Cascinu
- Department of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy
| | - A Casadei-Gardini
- Department of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy.
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Nakao E, Aoki H, Majima R, Hashimoto Y, Shibata R, Hayashi M, Ohno-Urabe S, Furusho A, Nishida N, Hirakata S, Fukumoto Y. The role of cellular senescence in aortic dissection. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1933] [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
Aortic dissection (AD) is a catastrophic disease that occurs suddenly. The acute mortality is high and those who survived frequently suffer from serious complications such as aneurysm formation and distal ischemia due to progressive destruction of the aortic walls. Currently, no predictor of AD onset is available nor therapeutic intervention to specifically prevent the progressive destruction in AD, because the molecular pathogenesis is largely unknown. Clinical and experimental studies highlighted the importance of inflammation in AD, although the regulatory mechanism of inflammation remains unclear. Recently, we found that cell proliferation precedes the inflammatory response in AD. Because cell proliferation causes cellular senescence that can induce inflammatory response, we hypothesized that cellular senescence participates in AD pathogenesis.
Objective
We investigated if cellular senescence contributes to AD development and progression in mouse AD model.
Methods and results
A mouse AD model was created by continuous infusion of beta-aminopropionitrile and angiotensin II (BAPN+AngII), where AD starts to develop in 3 days and occurs to most of the mice in 14 days accompanied by frequent AD rupture and death. Infusion of BAPN+AngII resulted in the induction of senescence markers Ink4a from day 3 before AD onset and persisted for the 14 days of the observational period.
Cellular senescence, as demonstrated by the expression of senescence-associated beta-galactosidase, was evident in intimal endothelial cells, medial smooth muscle cells, adventitial macrophages and fibroblasts. We examined the role of cellular senescence in AD pathogenesis by oral administration of ABT263 which is known as “senolytics” that eliminates senescent cells. ABT263 treatment reduced the expression of the senescence marker, prevented the death by AD rupture, and ameliorated the severity of AD lesion compared to the vehicle treatment. Transcriptome analysis revealed that ABT treatment suppressed the immune and inflammatory response in AD. Quantitative RT-PCR confirmed that ABT treatment prevented the induction of p21Cip1, interleukin-6, several chemokines and their receptors by 3-day infusion of BAPN+AngII.
Conclusions
These findings demonstrated that senescence of multiple cell types precedes AD development, which is likely to induce the inflammatory response. Elimination of senescent cells effectively prevented AD progression and death. Therefore, cellular senescence represents a potential predictor and a therapeutic target for AD.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Nakao
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume , Fukuoka , Japan
| | - H Aoki
- Cardiovascular Research Institute, Kurume University, Kurume , Fukuoka , Japan
| | - R Majima
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume , Fukuoka , Japan
| | - Y Hashimoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume , Fukuoka , Japan
| | - R Shibata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume , Fukuoka , Japan
| | - M Hayashi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume , Fukuoka , Japan
| | - S Ohno-Urabe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume , Fukuoka , Japan
| | - A Furusho
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume , Fukuoka , Japan
| | - N Nishida
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume , Fukuoka , Japan
| | - S Hirakata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume , Fukuoka , Japan
| | - Y Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume , Fukuoka , Japan
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Sugimoto N, Nakata K, Miyo M, Yoshioka S, Kagawa Y, Naito A, Tei M, Tamagawa H, Konishi K, Osawa H, Shingai T, Danno K, Nishida N, Sato G, Shimokawa T, Miyoshi N, Takahashi H, Uemura M, Yamamoto H, Murata K, Doki Y, Eguchi H. P-76 Phase II study of FOLFIRI plus ramucirumab with recurrent colorectal cancer refractory to adjuvant chemotherapy with oxaliplatin/fluoropyrimidine (RAINCLOUD). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.166] [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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Nakao E, Aoki H, Majima R, Hashimoto Y, Shibata R, Hayashi M, Ohno-Urabe S, Furusho A, Nishida N, Hirakata S, Fukumoto Y. The role of cellular senescence in aortic dissection. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3404] [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
Aortic dissection (AD) is a catastrophic disease that occurs suddenly. The acute mortality is high and those who survived frequently suffer from serious complications such as aneurysm formation and distal ischemia due to progressive destruction of the aortic walls. Currently, no reliable predictor is available for AD development and surgical intervention is the only therapeutic option to prevent the fatal events after AD development, because the pathogenesis of AD is largely unknown.
Clinical and experimental studies highlighted the importance of inflammation in AD pathogenesis, although the trigger of inflammation remains unclear. Recently, we found that cell proliferation precedes the inflammatory response in AD. Because cell proliferation triggers cellular senescence and senescent cells secrete of proinflammatory cytokines and matrix metalloproteinases, we hypothesized that cellular senescence may participate in AD pathogenesis.
Objective
We investigated if cellular senescence contributes to AD development and progression in a mouse model of AD.
Methods and results
A mouse AD model was created by continuous infusion of beta-aminopropionitrile and angiotensin II (BAPN+AngII), where AD starts to develop in 3 days and occurs to most of the mice in 14 days accompanied by frequent AD rupture and death. Infusion of BAPN+AngII resulted in the appearance of senescent cells that are positive for senescence-associated beta-galactosidase, and expression of senescence markers Arf and Ink4a in the aortic walls. Appearance of cellular senescence occurred in one day of BAPN+AngII infusion and continued throughout the observational period of 14 days. We examined the role of cellular senescence in AD pathogenesis by oral administration of ABT263 which is known as “senolytics” that eliminates senescent cells. ABT263 treatment reduced the expression of the senescence markers. In the vehicle-treated group, the mortality was 66.7% (12/18), whereas that of ABT263-treated group was 35% (14/20, P<0.05 by log-rank test). The severity of AD, as assessed by the lesion length in vehicle group was33.2±3.1 mm, whereas that in ABT263 group was 24.6±1.8 mm (P<0.05).
Conclusions
These findings demonstrated that cellular senescence precedes AD development, and ABT263 effectively prevented AD progression and death, indicating the involvement of cellular senescence in AD pathogenesis. Therefore, cellular senescence represents a potential predictor and a therapeutic target for AD.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- E Nakao
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - H Aoki
- Cardiovascular Research Institute, Kurume University, Kurume, Fukuoka, Japan
| | - R Majima
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Y Hashimoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - R Shibata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - M Hayashi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - S Ohno-Urabe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - A Furusho
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - N Nishida
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - S Hirakata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Y Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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Majima R, Aoki H, Shibata R, Nakao E, Hashimoto Y, Hayashi M, Ohno-Urabe S, Furushyo A, Nishida N, Hirakata S, Fukumoto Y. Involvement of FAK in aortic dissection: potential role in aortic interstitial cells. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2010] [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
Aortic dissection (AD) is a fatal disease where the intimomedial layer of the aorta suddenly fail. Although it is widely accepted that hemodynamic stress on the aortic wall triggers its destruction that is further promoted by inflammatory response as exemplified by the infiltration of neutrophils and macrophages, molecular mechanism is unknown for the link of aortic wall stress, inflammation and tissue destruction. In general, mechanical stress to the tissue is converted to the cellular response through the cell adhesion molecules and the activation of focal adhesion kinase (Fak). Although it has been reported that Fak is involved in pathogenesis of aortic aneurysm by promoting migration and activation of macrophages, its role in AD is unknown. We hypothesized that Fak may be involved in AD pathogenesis.
Purpose
We investigated the involvement of Fak in AD pathogenesis, focusing on its role in inflammatory cells.
Methods and results
We created a mouse model of AD by continuous infusion of beta-aminopropionitrile, a collagen crosslink inhibitor, and angiotensin II (BAPN + Ang II). Immunostaining for activated Fak revealed that Fak was not activated in normal aorta, but was activated in the infiltrating inflammatory cells and in interstitial cells of the aortic wall after AD development. We examined the role of Fak by oral administration of PND-1186, a specific Fak inhibitor, in mouse AD model. Vehicle-treated group showed 63.6% mortality, whereas PND-1186-treated group showed 20% mortality (P<0.01, n=20 for each group) in 14 days of the observational period. The aortic arch lesion, the most critical part in AD, was improved from 1.96±0.41 mm in vehicle group to 0.66±0.29 mm in PND group (P<0.05). We next examined the cell type-specific role of Fak in AD by creating macrophage and granulocyte-specific deletion of Fak driven by LysM-Cre and floxed Fak system. Unexpectedly, the genetic deletion of Fak in macrophages and granulocytes had no impact on the mortality nor the severity of AD.
Conclusions
These findings proved that Fak plays a critical role in AD progression and death. Because Fak is dispensable for macrophages and granulocytes, other cell types, possibly aortic wall interstitial cells, may be regulated by Fak in AD pathogenesis. Deciphering the role of Fak would provide the fundamental understanding of AD pathogenesis.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Majima
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - H Aoki
- Cardiovascular Research Institute of the Kurume University, Kurume, Japan
| | - R Shibata
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - E Nakao
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - Y Hashimoto
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - M Hayashi
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - S Ohno-Urabe
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - A Furushyo
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - N Nishida
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - S Hirakata
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - Y Fukumoto
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
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8
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Ogawa S, Yamamoto A, Jogo A, Nakano MM, Kageyama K, Sohgawa E, Nishida N, Kaminou T, Miki Y. Splenic Vein Diameter is a Risk Factor for the Portal Venous System Thrombosis After Partial Splenic Artery Embolization. Cardiovasc Intervent Radiol 2021; 44:921-930. [PMID: 33474605 PMCID: PMC8172394 DOI: 10.1007/s00270-020-02751-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 12/16/2020] [Indexed: 01/16/2023]
Abstract
Purpose Portal venous system thrombosis is a complication of partial splenic artery embolization, and pre-treatment risk assessment is thus important. The purpose of this study was to identify the risk factors for portal venous system thrombosis after partial splenic artery embolization. Materials and methods We retrospectively analyzed 67 consecutive patients who underwent contrast-enhanced computed tomography before and after first partial splenic artery embolization between July 2007 and October 2018. As risk factors, we investigated age, sex, hematological data, liver function, steroid use, heparin use, and findings from pre- and post-treatment computed tomography. Uni- and multivariate analyses were performed to evaluate the relationship between thrombus appearance or growth and these factors. Values of p < 0.05 were considered significant. Results Partial splenic artery embolization was technically successful in all 67 patients. Nine patients showed appearance or growth of thrombus. Univariate analysis showed maximum diameter of the splenic vein before treatment (p = 0.0076), percentage of infarcted spleen (p = 0.017), and volume of infarcted spleen (p = 0.022) as significant risk factors. Multivariate analysis showed significant differences in maximum diameter of the splenic vein before treatment (p = 0.041) and percentage of infarcted spleen (p = 0.023). According to receiver operating characteristic analysis, cutoffs for maximum diameter of the splenic vein and percentage of infarcted spleen for distinguishing the appearance or growth of thrombus were 17 mm and 58.2%. Conclusion Large maximum diameter of the splenic vein before partial splenic artery embolization and high percentage of infarcted spleen after partial splenic artery embolization were identified as risk factors for portal venous system thrombosis. Level of Evidence Level 4, Case Series
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Affiliation(s)
- Satoyuki Ogawa
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
| | - Akira Yamamoto
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan.
| | - Atsushi Jogo
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
| | - Mariko M Nakano
- Department of Radiology, National Hospital Organization Osaka Minami Medical Center, Osaka, Japan
| | - Ken Kageyama
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
| | - Etsuji Sohgawa
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
| | - Norifumi Nishida
- Department of Diagnostic Radiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Toshio Kaminou
- Department of Radiology, Tsukazaki Hospital, Himeji, Hyogo, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Japan
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9
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Nishida N, Furusho A, Aoki H, Ohno-Urabe S, Nishihara M, Hirakata S, Hayashi M, Ito S, Majima R, Hashimoto Y, Nakao E, Fukumoto Y. The role of B cells and IgG in aortic dissection. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3750] [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
Aortic dissection (AD) is one of the destructive and fatal aortic diseases, for which molecular pathogenesis is largely unknown. Recent studies have highlighted the importance of inflammatory response in AD. We and others reported that B cells and immunoglobulins participate in pathogenesis of abdominal aortic aneurysm, another form of aortic destructive disease, by promoting inflammatory response. It is not known whether and how B cells participate in AD pathogenesis.
Methods and results
Immunohistochemical staining of human AD tissue revealed that B cells were clustered together with T cells, macrophages and neutrophils at the entry site of AD with medial disruption. B cell cluster was also observed at the site of medial disruption in mouse model of AD that was induced by continuous infusion of beta-aminopropionitrile and angiotensin II (BAPN+AngII). In muMT mouse, which is deficient for B cells and immunoglobulins due to genetic deletion of immunoglobulin heavy chain, BAPN+AngII induced significantly less severe AD compared to that in wild type. Depositions of IgG and fibrinogen, one of the endogenous antigen for natural IgG, were observed after BAPN+AngII infusion before and after AD development in wild type mice. Deposition of fibrinogen was also observed in mMT mice after BAPN+AngII infusion. The rate of aortic rupture and sudden death was approximately 42% in wild type mice, while that in muMT mouse was 12% (P<0.05). Administration of mouse normal polyclonal IgG to muMT mice resulted in dramatic increase in aortic rupture and sudden death, starting at day 7 of BAPN+AngII infusion, and reaching 69% of rupture rate, indicating the critical role of IgG in AD.
Conclusion
These findings demonstrated B cells and IgG are critically involved in the destructive inflammation of AD pathogenesis. Further, the deposition of fibrinogen, one of the targets of natural IgG, precedes the development of AD. Our findings may provide the conceptual foundation of the diagnostic strategy for on-going tissue destruction and for the therapeutic opportunities to intervene the progressive tissue destruction in AD.
Funding Acknowledgement
Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Japan Society for the Promotion of Science
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Affiliation(s)
- N Nishida
- Kurume University School of Medicine, cardiovascular medicine, Kurume, Japan
| | - A Furusho
- Kurume University School of Medicine, cardiovascular medicine, Kurume, Japan
| | - H Aoki
- Cardiovascular Research Institute of the Kurume University, Kurume, Japan
| | - S Ohno-Urabe
- Kurume University School of Medicine, cardiovascular medicine, Kurume, Japan
| | - M Nishihara
- Kurume University School of Medicine, cardiovascular medicine, Kurume, Japan
| | - S Hirakata
- Kurume University School of Medicine, cardiovascular medicine, Kurume, Japan
| | - M Hayashi
- Kurume University School of Medicine, cardiovascular medicine, Kurume, Japan
| | - S Ito
- Kurume University School of Medicine, cardiovascular medicine, Kurume, Japan
| | - R Majima
- Kurume University School of Medicine, cardiovascular medicine, Kurume, Japan
| | - Y Hashimoto
- Kurume University School of Medicine, cardiovascular medicine, Kurume, Japan
| | - E Nakao
- Kurume University School of Medicine, cardiovascular medicine, Kurume, Japan
| | - Y Fukumoto
- Kurume University School of Medicine, cardiovascular medicine, Kurume, Japan
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10
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Rodrigues J, Leite B, Vasconcellos G, Dias LA, Muniz MJ, Espinosa MV, Nishida N, Ferrero MV, Reis B, Cabral ER. Socioeconomic and environmental status of riverside communities of Tapajós River, Brazil. Eur J Public Health 2020. [DOI: 10.1093/eurpub/ckaa166.333] [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] [Indexed: 11/14/2022] Open
Abstract
Abstract
Introduction
Public health care acknowledges socioeconomic factors as one of the multiple facets to promote or protect individual or collective health. Understanding and being more acquainted with the dynamics carried out in riverside communities is fundamental to investing in policies aimed at fighting diseases and illnesses that are particular to those communities.
Objective
Describing socioeconomic characteristics, healthcare infrastructure, and occupational activities of population from riverside communities along Tapajós river, Brazil.
Methodology
A descriptive study with 96 residents of communities of Tapajós river, Brazil. Participants have answered a semi-structure questionnaire and the analyses were descriptive and the variable categories were expressed as frequencies.
Results
There was a predominance of male participants (77.09%), incomplete elementary school (58.51%), involved in agricultural sector (85.10%), with a family income up to 1 minimum wage (68.81%). However, only 21.50% have declared making their living exclusively out of agriculture. Seedlings and seeds are mainly obtained through an exchange system running inside the community. In relation to infrastructure, the water comes from artesian wells (68.88%) and 51.63% claim not treating water whatsoever. All interviewees mentioned the lack of a sewage system and residues are taken to a rudimentary cesspool (76.59%). Waste produced by the community is burned out (93.61%). The main difficulties pointed out by the interviewees were: transportation (44.94%), health (32.14%), communication (21.42%) and government cooperation (15.47%).
Conclusions
The communities in this project show similar structural dynamic based on subsistence family agriculture and poor infrastructure of basic services. The data collected can be the basis for future public policies aiming at the promotion of food production autonomy, economic autonomy, and improvement of health indicators of these communities.
Key messages
Contextualizing the structural dynamic of vulnerable populations is key to plan actions aimed at tackling and dealing with social determinants involved in the health-illness process. Contextualizing the structural dynamic of vulnerable populations is fundamental to guide strategies aimed at intervening in the social and health determinants.
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Affiliation(s)
- J Rodrigues
- Public Health, São Leopoldo Mandic University, Campinas, Brazil
| | - B Leite
- Public Health, São Leopoldo Mandic University, Campinas, Brazil
| | - G Vasconcellos
- Public Health, São Leopoldo Mandic University, Campinas, Brazil
| | - L A Dias
- Public Health, São Leopoldo Mandic University, Campinas, Brazil
| | - M J Muniz
- Public Health, São Leopoldo Mandic University, Campinas, Brazil
| | - M V Espinosa
- Public Health, São Leopoldo Mandic University, Campinas, Brazil
| | - N Nishida
- Public Health, São Leopoldo Mandic University, Campinas, Brazil
| | - M V Ferrero
- Public Health, São Leopoldo Mandic University, Campinas, Brazil
| | - B Reis
- Public Health, São Leopoldo Mandic University, Campinas, Brazil
| | - E R Cabral
- Public Health, São Leopoldo Mandic University, Campinas, Brazil
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11
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Majima R, Aoki H, Nakao E, Hashimoto Y, Ito S, Hayashi M, Ohno-urabe S, Frusho A, Nishida N, Hirakata S, Fukumoto Y. Abstract 351: Focal Adhesion Kinase Promotes Tissue Destruction in Aortic Dissection in Mice. Circ Res 2020. [DOI: 10.1161/res.127.suppl_1.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aortic dissection (AD) is a fatal disease due to the sudden destruction of the aortic medial layer. Currently, Molecular pathogenesis of AD is unknown. We investigated the role of focal adhesion kinase (FAK), a mechanosensitive signal transducer, in AD pathogenesis. We created a mouse model of AD with a continuous infusion of beta-aminopropionitrile (150 mg/kg/day), a collagen crosslink inhibitor, and angiotensin II (1,000 ng/kg/min) (BAPN + Ang II) by osmotic pumps. This AD model showed about 60% mortality within 2 weeks due to AD rupture. Immunohistochemical staining for activated FAK revealed that FAK was inactive in normal mouse aorta, but was strongly activated in the aortic walls after BAPN + Ang II infusion. Immunofluorescence staining showed that FAK was activated mainly in smooth muscle cells after the BAPN + Ang II challenge. Western blot analysis revealed that FAK was activated in 3 days after BAPN + Ang II infusion before AD development, followed by transient reduction at day 7, and re-activation after AD development at day 14. We examined the effect of PND-1186, an orally available FAK inhibitor, on the severity as determined by the AD lesion length and the mortality of AD. Mice were administered with either vehicle or PND-1186 (150 mg/kg twice daily by oral gavage) during the BAPN + Ang II challenge (n=20 for each group). Administration of PND-1186 resulted in significant reduction in the lesion length of AD (vehicle; 12.5 ± 1.65 mm, PND; 7.46 ± 1.88 mm, P<0.05). The suppressive effect of PND-1186 was most significant in the aortic arch (vehicle; 2.13 ± 0.29 mm, PND; 0.85 ± 0.22 mm, P<0.01). Furthermore, PND-1186 significantly improved the survival rate of mice from 40.0% to 80.0% (P<0.01). Transcriptome analysis indicated that destruction and inflammation of tissue were suppressed by PND-1186 administration. These findings indicated that FAK plays an important role in AD pathogenesis, possibly by transducing the pathological stress to the tissue destructive response in the aortic walls. We propose that FAK is a potential therapeutic target to limit the fatal destruction of aortic walls in AD.
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12
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Nishiura A, Takakuwa T, Miura A, Otomaru I, Araki T, Fujitani Y, Nishida N, Yamamura R. [Spontaneous Splenic Rupture with Angioimmunoblastic T-Cell Lymphoma Successfully Treated Using Transcatheter Arterial Embolization]. Gan To Kagaku Ryoho 2020; 47:1097-1099. [PMID: 32668860] [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: 06/11/2023]
Abstract
A 75-year-old woman presented to our hospital with a history of fever, cervical lymphadenopathy, and fatigue. Computed tomography(CT)revealed systemic lymphadenopathy with prominent splenomegaly. Axillary lymph node biopsy results revealed diffuse proliferation of atypical lymphoid cells with arborizing high endothelial venules. Immunohistochemical staining was positive for CD3, CD5, and CD10, but negative for CD20 and CD79a. Given these findings, a diagnosis of angioimmunoblastic T-cell lymphoma(AITL)was made. Due to the extremely high tumor burden, pre-therapy with corticosteroids was initiated. However, the patient suddenly went into hemorrhagic shock. Contrast-enhanced CT revealed abdominal bleeding due to splenic rupture. Bleeding was rapidly controlled using transcatheter arterial embolization(TAE). Five days after TAE, mini-CHOP therapy was initiated. Splenomegaly is common in hematologic disease. Owing to the lethality of the condition, in cases of progressive anemia with splenomegaly in patients with hematologic disease, the possibility of splenic rupture should be considered. Since TAE carries no risk of post-splenectomy infection and allows timely resumption of chemotherapy, it could be considered as one of the preferred treatment choices for splenic rupture in hemodynamically unstable patients.
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13
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Ito S, Hashimoto Y, Majima R, Nakao E, Aoki H, Nishihara M, Ohno-Urabe S, Furusho A, Hirakata S, Nishida N, Hayashi M, Kuwahara K, Fukumoto Y. MRTF-A promotes angiotensin II-induced inflammatory response and aortic dissection in mice. PLoS One 2020; 15:e0229888. [PMID: 32208430 PMCID: PMC7092993 DOI: 10.1371/journal.pone.0229888] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 02/18/2020] [Indexed: 12/20/2022] Open
Abstract
Aortic dissection (AD) is a major cause of acute aortic syndrome with high mortality due to the destruction of aortic walls. Although recent studies indicate the critical role of inflammation in the disease mechanism of AD, it is unclear how inflammatory response is initiated. Here, we demonstrate that myocardin-related transcription factor A (MRTF-A), a signal transducer of humoral and mechanical stress, plays an important role in pathogenesis of AD in a mouse model. A mouse model of AD was created by continuous infusion of angiotensin II (AngII) that induced MRTF-A expression and caused AD in 4 days. Systemic deletion of Mrtfa gene resulted in a marked suppression of AD development. Transcriptome and gene annotation enrichment analyses revealed that AngII infusion for 1 day caused pro-inflammatory and pro-apoptotic responses before AD development, which were suppressed by Mrtfa deletion. AngII infusion for 1 day induced pro-inflammatory response, as demonstrated by expressions of Il6, Tnf, and Ccl2, and apoptosis of aortic wall cells, as detected by TUNEL staining, in an MRTF-A-dependent manner. Pharmacological inhibition of MRTF-A by CCG-203971 during AngII infusion partially suppressed AD phenotype, indicating that acute suppression of MRTF-A is effective in preventing the aortic wall destruction. These results indicate that MRTF-A transduces the stress of AngII challenge to the pro-inflammatory and pro-apoptotic responses, ultimately leading to AD development. Intervening this pathway may represent a potential therapeutic strategy.
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Affiliation(s)
- Sohei Ito
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yohei Hashimoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Ryohei Majima
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Eichi Nakao
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hiroki Aoki
- Cardiovascular Research Institute, Kurume University, Kurume, Japan
| | - Michihide Nishihara
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Satoko Ohno-Urabe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Aya Furusho
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Saki Hirakata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Norifumi Nishida
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Makiko Hayashi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Koichiro Kuwahara
- Department of Cardiovascular Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
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14
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Takahashi Y, Saito S, Yamamoto Y, Uehara T, Yokota C, Sakai G, Nishida N, Takahashi R, Kalaria RN, Toyoda K, Nagatsuka K, Ihara M. Visually-Rated Medial Temporal Lobe Atrophy with Lower Educational History as a Quick Indicator of Amnestic Cognitive Impairment after Stroke. J Alzheimers Dis 2020; 67:621-629. [PMID: 30584149 DOI: 10.3233/jad-180976] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Time and resource limitations prevent cognitive assessment in acute-to-subacute settings, even in comprehensive stroke centers. OBJECTIVE To assess cognitive function in acute stroke patients undergoing routine clinical, laboratory, and radiological investigations, with a view to improving post-stroke care and treatment. METHODS Sixty-nine patients (72.6±11.1 years; 65% male) were prospectively enrolled within 14 days of acute ischemic stroke. Patients with altered consciousness, aphasia, or dysarthria were excluded. Clinical features including modified Rankin and NIH stroke scales, and vascular risk factors were assessed, as well as neuroimaging parameters by semi-quantitative evaluation of medial temporal lobe atrophy (MTLA) using MRA source images, FLAIR images for white matter changes (Fazekas scores), and T2∗ images for cerebral microbleeds. Neuropsychological screening was conducted using the Montreal Cognitive Assessment (MoCA) test. Univariate and multivariate analyses were used to evaluate the influence of variables on MoCA total and subscale scores. RESULTS Lower MoCA scores of 22 or less were associated with MTLA [OR (95% CI), 5.3 (1.0-27.5); p = 0.045], education years [OR (95% CI), 0.71 (0.55-0.91); p = 0.007], and modified Rankin scale at discharge [OR (95% CI), 2.4 (1.3-4.5); p = 0.007]. The delayed recall MoCA score was correlated with MTLA (r = - 0.452, p < 0.001), periventricular (r = - 0.273, p = 0.024), and deep (r = - 0.242, p = 0.046), white matter changes. CONCLUSIONS MTLA, together with lower educational history, are quick indicators of amnestic cognitive impairment after stroke. The association between cognitive impairment and physical disability at discharge may signify the importance of earlier cognitive assessment.
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Affiliation(s)
- Yukako Takahashi
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan.,Department of Neurology, Kyoto University Graduate School of Medicine, Osaka, Japan
| | - Satoshi Saito
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yumi Yamamoto
- Department of Regenerative Medicine and Tissue Engineering, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Toshiyuki Uehara
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.,Department of Stroke Rehabilitation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Chiaki Yokota
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.,Department of Stroke Rehabilitation, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Go Sakai
- Department of Diagnostic Radiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Norifumi Nishida
- Department of Diagnostic Radiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Osaka, Japan
| | - Raj N Kalaria
- Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle, UK
| | - Kazunori Toyoda
- Department of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kazuyuki Nagatsuka
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
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15
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Jogo A, Yamamoto A, Kaminoh T, Nakano M, Kageyama K, Sohgawa E, Hamamoto S, Sakai Y, Hamuro M, Nishida N, Miki Y. Utility of low-dose gelatin sponge particles and 5% ethanolamine oleate iopamidol mixture in retrograde transvenous obliteration (GERTO) for gastric varices. Br J Radiol 2020; 93:20190751. [PMID: 32017608 DOI: 10.1259/bjr.20190751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To determine the utility of low-dose gelatin sponge particles and 5% ethanolamine oleate iopamidol (EOI) mixture in retrograde transvenous obliteration (GERTO) for gastric varices (GV). METHODS 57 consecutive patients who underwent balloon-occluded retrograde transvenous obliteration (B-RTO) for GV were divided into three groups with Hirota's grade by balloon-occluded retrograde transvenous venography. Hirota's Grade 1 patients were assigned to G1 group and underwent treatment with 5% EOI. Grade ≥ 2 patients prior to August 2015 were G ≥ 2 group treated with 5% EOI, and those treated thereafter were GERTO group. The amount of EOI used per unit GV volume (EOI/GV ratio), the times to embolization and recurrence rate of GV were evaluated. RESULTS The EOI/GV ratio was 0.66 ± 0.19 in G1, 1.5 ± 0.8 in G ≥ 2, and 0.58 ± 0.23 in GERTO (G ≥ 2 vs GERTO, p < 0.0001). The times to embolization were 26.5 ± 10.5 min for G1, 39.2 ± 26.8 for G ≥ 2, and 21.4 ± 9.4 for GERTO (G ≥ 2 vs GERTO, p = 0.005). The recurrence rate was not significantly different in any of the groups. CONCLUSION GERTO was performed in lower amount of sclerosants and in less time compared to conventional B-RTO in Hirota's grade ≥2. ADVANCES IN KNOWLEDGE Feasibility of low-dose gelatin sponge particles and 5% EOI mixture as sclerosants for GV.
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Affiliation(s)
- Atsushi Jogo
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Akira Yamamoto
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | - Mariko Nakano
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Ken Kageyama
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Etsuji Sohgawa
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shinichi Hamamoto
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yukimasa Sakai
- Radiology, National Hospital Organization Osaka Minami Medical Center, Osaka, Japan
| | - Masao Hamuro
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | | | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Osaka, Japan
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16
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Hirakata S, Aoki H, Ohno-Urabe S, Nishihara M, Furusho A, Nishida N, Ito S, Hayashi M, Yasukawa H, Imaizumi T, Hiromatsu S, Tanaka H, Fukumoto Y. Genetic Deletion of Socs3 in Smooth Muscle Cells Ameliorates Aortic Dissection in Mice. JACC Basic Transl Sci 2020; 5:126-144. [PMID: 32140621 PMCID: PMC7046542 DOI: 10.1016/j.jacbts.2019.10.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 01/16/2023]
Abstract
Stat3, a major signaling molecule for proinflammatory cytokines including IL-6, was activated both in inflammatory cells and in SMC in the aortic walls of human AD and mouse AD model. SMC-specific deletion of Socs3 enhanced Stat3 activation in SMC, induced moderate proinflammatory response in the aortic walls, and ameliorated AD in mice. SmSocs3-KO aortas showed increases in fibroblasts, adventitial collagen fibers, and tensile strength of the aortic walls. IL-6-stimulated SMC in culture secreted humoral factor(s) that promoted proliferative response of fibroblasts.
Aortic dissection (AD) is the acute destruction of aortic wall and is reportedly induced by inflammatory response. Here we investigated the role of smooth muscle Socs3 (a negative regulator of Janus kinases/signal transducer and activator of transcription signaling) in AD pathogenesis using a mouse model generated via β-aminopropionitrile and angiotensin II infusion. Socs3 deletion specifically in smooth muscle cells yielded a chronic inflammatory response of the aortic wall, which was associated with increased fibroblasts, reinforced aortic tensile strength, and less-severe tissue destruction. Although an acute inflammatory response is detrimental in AD, smooth muscle-regulated inflammatory response seemed protective against AD.
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Key Words
- AD, aortic dissection
- AngII, angiotensin II
- BAPN, β-aminopropionitrile
- ECM, extracellular matrix
- IL, interleukin
- Jak/Stat
- Jnk, c-Jun N-terminal kinases
- KO, knockout
- Lox, lysyl oxidase
- SM2, smooth muscle myosin heavy chain
- SMA, smooth muscle α-actin
- SMC, smooth muscle cell
- SMemb, embryonic isoform of myosin heavy chain
- Socs, suppressor of cytokine signaling
- Stat, signal transducer and activator of transcription
- WT, wild type
- aortic dissection
- inflammation
- p, phosphorylated
- smSocs3-KO, knockout of the smooth muscle cell Socs3
- smooth muscle cells
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Affiliation(s)
- Saki Hirakata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hiroki Aoki
- Cardiovascular Research Institute, Kurume University, Kurume, Japan
- Address for correspondence: Dr. Hiroki Aoki, Cardiovascular Research Institute, Kurume University, 67 Asahimachi, Kurume, Fukuoka 830-0011, Japan.
| | - Satoko Ohno-Urabe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Michihide Nishihara
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Aya Furusho
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Norifumi Nishida
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Sohei Ito
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Makiko Hayashi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hideo Yasukawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | | | - Sinichi Hiromatsu
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hiroyuki Tanaka
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
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Nishida N, Aoki H, Ohno-Urabe S, Nishihara M, Furusho A, Hirakata S, Hayashi M, Ito S, Yamada H, Hirata Y, Yasukawa H, Imaizumi T, Tanaka H, Fukumoto Y. High Salt Intake Worsens Aortic Dissection in Mice: Involvement of IL (Interleukin)-17A-Dependent ECM (Extracellular Matrix) Metabolism. Arterioscler Thromb Vasc Biol 2019; 40:189-205. [PMID: 31694392 PMCID: PMC6946107 DOI: 10.1161/atvbaha.119.313336] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE Aortic dissection (AD) is a fatal disease that occurs suddenly without preceding clinical signs or symptoms. Although high salt intake is a proposed risk factor for cardiovascular diseases, the relationship between AD and high salt intake has not been clarified. We examined the effect of high-salt challenge on a mouse AD model. Approach and Results: AD was induced in male mice by continuous infusion of β-aminopropionitrile and Ang II (angiotensin II). High-salt challenge exacerbated aortic wall destruction in AD. Deletion of Il17a (IL-17KO [IL (interleukin)-17A knockout]) did not affect the AD phenotype at baseline, but it abolished the high salt-induced worsening of the aortic destruction. Unexpectedly, aortas of IL-17KO mice exhibited global changes in ECM (extracellular matrix)-related genes without alteration of proinflammatory genes, altered architecture of collagen fibers, and reduced stiffness before AD induction. The aortas of IL-17KO mice were less sensitive to AD-inducing stimuli, as shown by the induction of phenotypic modulation markers SMemb and vimentin, suggesting a reduced stress response. The aortas of IL-17KO mice had a higher population of smooth muscle cells with nuclear-localized phosphorylated Smad2, indicative of TGFβ (transforming growth factor-beta) signal activation. Consistently, pretreatment of smooth muscle cells in culture with IL-17A blunted the activation of Smad2 by TGFβ1. CONCLUSIONS These findings indicate that high salt intake has a worsening effect on AD in the context of high aortic wall stiffness, which is under the control of IL-17A through ECM metabolism. Therefore, salt restriction may represent a low-cost and practical way to reduce AD risk.
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Affiliation(s)
- Norifumi Nishida
- From the Division of Cardiovascular Medicine, Department of Internal Medicine (N.N., S.O.-U., M.N., A.F., S.H., M.H., S.I., H. Yasukawa, Y.F.), Kurume University School of Medicine, Japan
| | - Hiroki Aoki
- Cardiovascular Research Institute, Kurume University, Japan (H.A.)
| | - Satoko Ohno-Urabe
- From the Division of Cardiovascular Medicine, Department of Internal Medicine (N.N., S.O.-U., M.N., A.F., S.H., M.H., S.I., H. Yasukawa, Y.F.), Kurume University School of Medicine, Japan
| | - Michihide Nishihara
- From the Division of Cardiovascular Medicine, Department of Internal Medicine (N.N., S.O.-U., M.N., A.F., S.H., M.H., S.I., H. Yasukawa, Y.F.), Kurume University School of Medicine, Japan
| | - Aya Furusho
- From the Division of Cardiovascular Medicine, Department of Internal Medicine (N.N., S.O.-U., M.N., A.F., S.H., M.H., S.I., H. Yasukawa, Y.F.), Kurume University School of Medicine, Japan
| | - Saki Hirakata
- From the Division of Cardiovascular Medicine, Department of Internal Medicine (N.N., S.O.-U., M.N., A.F., S.H., M.H., S.I., H. Yasukawa, Y.F.), Kurume University School of Medicine, Japan
| | - Makiko Hayashi
- From the Division of Cardiovascular Medicine, Department of Internal Medicine (N.N., S.O.-U., M.N., A.F., S.H., M.H., S.I., H. Yasukawa, Y.F.), Kurume University School of Medicine, Japan
| | - Sohei Ito
- From the Division of Cardiovascular Medicine, Department of Internal Medicine (N.N., S.O.-U., M.N., A.F., S.H., M.H., S.I., H. Yasukawa, Y.F.), Kurume University School of Medicine, Japan
| | - Hiroshi Yamada
- Department of Biological Functions Engineering, Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, Kitakyushu, Japan (H. Yamada)
| | - Yuichiro Hirata
- Division of Cardiovascular Surgery, Department of Surgery (Y.H., H.T.), Kurume University School of Medicine, Japan
| | - Hideo Yasukawa
- From the Division of Cardiovascular Medicine, Department of Internal Medicine (N.N., S.O.-U., M.N., A.F., S.H., M.H., S.I., H. Yasukawa, Y.F.), Kurume University School of Medicine, Japan
| | - Tsutomu Imaizumi
- International University of Health and Welfare, Fukuoka, Japan (T.I.)
| | - Hiroyuki Tanaka
- Division of Cardiovascular Surgery, Department of Surgery (Y.H., H.T.), Kurume University School of Medicine, Japan
| | - Yoshihiro Fukumoto
- From the Division of Cardiovascular Medicine, Department of Internal Medicine (N.N., S.O.-U., M.N., A.F., S.H., M.H., S.I., H. Yasukawa, Y.F.), Kurume University School of Medicine, Japan
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18
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Kageyama K, Yamamoto A, Jogo A, Nota T, Murai K, Ogawa S, Nakano MM, Sohgawa E, Hamamoto S, Hamuro M, Kaminou T, Nishida N, Takahashi K, Yamamoto K, Miki Y. Usefulness of Venous Pressure Measurement in Endovascular Treatment of Budd-Chiari Syndrome: A Retrospective Cohort Study. Intern Med 2019; 58:2923-2929. [PMID: 31243212 PMCID: PMC6859396 DOI: 10.2169/internalmedicine.2704-19] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Objective Therapeutic predictors derived from the venous pressure before therapy have not been identified for Budd-Chiari syndrome (BCS). The aim of this study was to determine whether or not measuring the distal pressure or pressure gradient was useful for predicting treatment efficacy in BCS. Methods We retrospectively analyzed seven consecutive patients diagnosed with symptomatic BCS at our hospital between 2008 and 2017. Distal and proximal venous pressures at occlusion sites of BCS were measured before treatment in all cases. The pressure gradient was defined as the difference between distal and proximal venous pressures. A receiver operating characteristics (ROC) analysis was performed for venous pressures. Results Percutaneous old balloon angioplasty (POBA) was performed in seven cases, with technical success achieved in all cases (100%). No complications were encountered. The median primary patency was 574 (interquartile range, 439.5-1,056.5) days. The 1-year primary patency rate was 71.73%. Six cases (85.7%) showed resolution of symptoms, representing clinical success. The ROC analysis revealed a high distal pressure (area under the ROC curve = 0.83, cut-off=12 mmHg) as a predictor of treatment efficacy of POBA for symptomatic BCS. In addition, the pressure gradient was considered significant from a clinical perspective, because the 6 successful cases with resolution of symptoms showed a large pressure gradient (range, 8-21 mmHg) before treatment, whereas the failed case showed a relatively small pressure gradient (7 mmHg). Conclusion High distal pressure and a large pressure gradient might predict the treatment efficacy of balloon angioplasty for symptomatic BCS.
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Affiliation(s)
- Ken Kageyama
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Akira Yamamoto
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Atsushi Jogo
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Takehito Nota
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Kazuki Murai
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Satoyuki Ogawa
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Mariko M Nakano
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Etsuji Sohgawa
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Shinichi Hamamoto
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Masao Hamuro
- Department of Radiology, Izumiotsu Municipal Hospital, Japan
| | - Toshio Kaminou
- Department of Radiology, National Hospital Organization Osaka Minami Medical Center, Japan
| | - Norifumi Nishida
- Department of Radiology, Osaka Saiseikai Nakatsu Hospital, Japan
| | - Kanae Takahashi
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Japan
| | - Kouji Yamamoto
- Department of Medical Statistics, Osaka City University Graduate School of Medicine, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
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Majima R, Aoki H, Hashimoto Y, Hayashi M, Ohno-Urabe S, Furusho A, Nishida N, Hirakata S, Fukumoto Y. P6494Activation of focal adhesion kinase is involved in pathogenesis of aortic dissection in mice. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1084] [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: 11/15/2022] Open
Abstract
Abstract
Background
Aortic dissection (AD) is a fatal disease where the media of the aorta suddenly fail. Currently, Molecular pathogenesis of AD is unknown. Recently, we discovered that the activity of MRTF-A, a mechanosensitive transcriptional regulator, promotes AD development. The activity of MRTF-A is regulated by mechanical stress to cells, which is transduced through focal adhesion and actin dynamics. However, it is currently unknown whether the mechanotransduction mechanism is involved in AD pathogenesis.
Purpose
We investigated the role of focal adhesion kinase (FAK), a signaling molecule that transduces mechanostress from focal adhesion to actin dynamics, in AD pathogenesis.
Methods
We created a mouse model of AD with a continuous infusion of beta-aminopropionitrile (150 mg/kg/day), a collagen crosslink inhibitor, and angiotensin II (1,000 ng/kg/min) (BAPN + AngII) by an osmotic pump. This model caused about 60% death in all mice due to AD rupture within 2 weeks. In this model, we examined the severity and mortality rate of aortic dissection after 2 weeks in mice administered with PND-1186, an orally available FAK inhibitor, and in those treated with vehicle (n=20 for each group). We performed immunochemical staining, immunofluorescence staining and Western blot for activated (phosphorylated) FAK (pFAK) to evaluate the activation status of FAK in the aortic tissue. We also performed transcriptome analysis of the aortic tissue in with and without PND-1186 with BAPN + AngII stimulation before AD development.
Results
Immunochemical staining revealed that FAK was inactive in normal mouse aorta, but was strongly activated in the aortic walls after AD development. Immunofluorescence staining showed that FAK was activated mainly in smooth muscle cells after AD development. Western blot analysis also revealed that FAK was activated in 3 days after BAPN + AngII infusion before AD development, followed by transient reduction at day 7, and re-activation after AD at day 14. Significantly, administration of PND-1186 resulted in a significant reduction in the severity of AD in the aortic arch (1.96±0.41 mm in vehicle group, 0.66±0.29 mm in PND group, P<0.05). In addition, survival rate improved from 36.4% to 80.0% by administration of PND-1186 (P<0.01). In immunofluorescence staining, the PND-1186 treated group showed weaker staining of pFAK. Transcriptome analysis showed that genes for hematopoiesis and immune system were suppressed in PND-1186 treated group.
Conclusions
These findings proved that FAK plays a central role in the pathogenesis of AD probably by transmitting pathological stress to the aortic wall to cause tissue destruction. We propose that FAK is a potential therapeutic target for limiting the fatal destruction of the aortic wall of AD.
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Affiliation(s)
- R Majima
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - H Aoki
- Cardiovascular Research Institute of the Kurume University, Kurume, Japan
| | - Y Hashimoto
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - M Hayashi
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - S Ohno-Urabe
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - A Furusho
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - N Nishida
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - S Hirakata
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
| | - Y Fukumoto
- Kurume University, Division of Cardiovascular Medicine, Kurume, Japan
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20
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Hashimoto Y, Aoki H, Majima R, Hayashi M, Ito S, Ohno-Urabe S, Furusho A, Nishida N, Hirakata S, Fukumoto Y. P6493Syk activation is a defense mechanism in murine model of aortic dissection. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.1083] [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
Aortic dissection (AD) is a serious clinical condition with unknown etiology that frequently results in fatal outcome. Recent studies showed essential role of inflammatory response both in promoting AD and aortic aneurysm (AA). However, the difference of the molecular pathogenesis between AD and AA is unclear. Previously, we reported that Syk, a tyrosine kinase that regulates differentiation and activation of inflammatory cells, promotes AA formation in a mouse model.
Objective
In the current study, we investigated the role of Syk in AD.
Methods and results
A mouse AD model was created by continuous infusion of beta-aminopropionitrile (125 mg/kg/day) and angiotensin II (1,000 ng/min/kg) (BAPN+AngII), which caused AD in approximately 80% of mice within 14 days. Immunohistochemical staining for activated (phosphorylated) Syk (pSyk) revealed that Syk was inactive in normal mouse aorta, but was activated in the aortic walls after AD development. Double immunofluorescence staining for pSyk and smooth muscle alpha actin showed that Syk was active not only in the infiltrating inflammatory cells, but also in smooth muscle cells in AD tissue. Western blot analysis revealed that BAPN+AngII treatment caused Syk activation at 3 days before AD development, followed by transient suppression, and reactivation at 14 days after AD development. We examined the significance of Syk activation in AD by treating mice with fostamatinib, a specific Syk inhibitor, before and during BAPN+AngII infusion. Notably, fostamatinib-treated group developed more severe AD compared to the vehicle-treated group. The AD lesion length was 3.80±0.86 mm for vehicle group and 8.87±1.69 mm for fostamatinib group (P<0.05, n=12 for each group). In addition, fostamatinib significantly worsened the mortality of mice due to the rupture of the aorta from 0% to 42% (P<0.05, n=12 for each group). Transcriptome analysis revealed that fostamatinib suppressed both positive and negative regulators of immune response, defense response and inflammatory response.
Conclusions
These findings uncovered the previously unrecognized role of Syk for protecting the aortic tissue in AD pathogenesis, and suggested fundamentally different disease mechanisms of AD and AA.
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Affiliation(s)
- Y Hashimoto
- Kurume University School of Medicine, Kurume, Japan
| | - H Aoki
- Kurume University School of Medicine, Cardiovascular Research Institute, Kurume, Japan
| | - R Majima
- Kurume University School of Medicine, Kurume, Japan
| | - M Hayashi
- Kurume University School of Medicine, Kurume, Japan
| | - S Ito
- Kurume University School of Medicine, Kurume, Japan
| | - S Ohno-Urabe
- Kurume University School of Medicine, Kurume, Japan
| | - A Furusho
- Kurume University School of Medicine, Kurume, Japan
| | - N Nishida
- Kurume University School of Medicine, Kurume, Japan
| | - S Hirakata
- Kurume University School of Medicine, Kurume, Japan
| | - Y Fukumoto
- Kurume University School of Medicine, Kurume, Japan
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21
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Abstract
Objective Balloon-occluded retrograde transvenous obliteration (B-RTO) for gastric varices (GV) is associated with drawbacks including a postoperative increase in portal pressure and the risk of subsequent worsening of esophageal varices (EV). Selective B-RTO that embolizes only the varices may have the potential to minimize such risks. The aim of this study is to retrospectively compare the postoperative course of patients after selective B-RTO (Group S) and conventional B-RTO (Group B). Methods One hundred four patients treated from January 2007 to April 2012 were classified into Groups S (n=5) and B (n=99). In the univariate analysis, the volume of 5% ethanolamine oleate iopamiodol (EOI) administered at baseline and the GV blood flow on endoscopic ultrasound after B-RTO were considered as covariates. The rates of GV recurrence and EV aggravation was also compared between Groups B and S. Results In Group S, the volume of 5% EOI was significantly lower (Group S vs. Group B: 14.6±5.5 vs. 28.5±16.4 mL; p=0.0012) and the rate of EV aggravation was lower in comparison to Group B (p=0.045). However, in Group S, the rate of complete eradication of GV blood flow was significantly lower (Group S vs. Group B: 0% vs. 89.9%; p<0.001) and the rate of re-treatment for GV was higher in comparison to Group B (Group S vs. Group B: 60% vs. 1.0%; p<0.001). Conclusion Selective B-RTO for GV could minimize the risk of a worsening of EV or reduce the amount of sclerosants; however, the rate of recurrence was high in comparison to conventional B-RTO.
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Affiliation(s)
- Atsushi Jogo
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Norifumi Nishida
- Department of Radiology, Osaka Saiseikai Nakatsu Hospital, Japan
| | - Akira Yamamoto
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Ken Kageyama
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Mariko Nakano
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Etsuji Sohgawa
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Shinichi Hamamoto
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Masao Hamuro
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, Japan
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22
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Nakano MM, Yamamoto A, Nishida N, Hamuro M, Hamamoto S, Jogo A, Sohgawa E, Kageyama K, Minami T, Miki Y. Risk factors for local recurrence of hepatocellular carcinoma after transcatheter arterial chemoembolization with drug-eluting beads (DEB-TACE). Jpn J Radiol 2019; 37:543-548. [DOI: 10.1007/s11604-019-00840-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 04/18/2019] [Indexed: 12/11/2022]
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23
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Sakima A, Satonaka H, Nishida N, Yatsu K, Arima H. Optimal blood pressure targets for patients with hypertension: a systematic review and meta-analysis. Hypertens Res 2019; 42:483-495. [PMID: 30948822 DOI: 10.1038/s41440-018-0123-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 08/27/2018] [Accepted: 08/30/2018] [Indexed: 12/11/2022]
Abstract
Optimal blood pressure (BP) targets for hypertension have been an important clinical issue but have been elusive. The Systolic Blood Pressure Intervention Trial (SPRINT) showed significant benefits of intensive BP-lowering treatment with a target systolic BP level of < 120 mm Hg on major cardiovascular (CV) events and mortality, whereas there was a modest increase in renal events related to BP-lowering treatment. We searched the PubMed, Cochrane CENTRAL, and ICHUSHI databases for randomized trials that assigned participants to intensive versus usual BP-lowering treatment with different BP targets. The outcomes were major CV events, all-cause death, myocardial infarction, stroke, heart failure, renal events, and adverse events. Nineteen trials that enrolled a total of 55,529 participants with a mean follow-up duration ranging from 1.6 to 12.2 years were included in the present analysis. There was a significant reduction in major CV events, myocardial infarction, and stroke and a trend toward a reduction in heart failure associated with intensive BP-lowering treatment, but no differences in the risks of all-cause death, renal events, or adverse events were observed between the randomized groups. Subgroup analyses indicated that intensive BP-lowering treatment with a target of < 130/80 mm Hg and/or achievement of BP < 130/80 mm Hg were associated with a significant reduction in major CV events compared with the usual group. In conclusion, intensive BP-lowering treatment reduces the risk of CV events. A target BP level of < 130/80 mm Hg appears to be optimal for CV protection in patients with hypertension.
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Affiliation(s)
- Atsushi Sakima
- Health Administration Center, University of the Ryukyus, Nishihara, Japan. .,Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Graduate School of Medicine, Nishihara, Japan.
| | - Hiroshi Satonaka
- Department of Cardiology and Nephrology, Dokkyo Medical University, Mibu, Japan
| | - Norifumi Nishida
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Keisuke Yatsu
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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24
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Morikawa N, Nakayoshi T, Yoshimura H, Watanabe M, Kumanomido J, Furusho A, Fukui D, Eto K, Nishida N, Nishihara M, A Kamiya C, Fukumoto Y. The Use of Bromocriptine for Peripartum Cardiomyopathy after Twin Delivery via Oocyte Donation. Intern Med 2019; 58:541-544. [PMID: 30568125 PMCID: PMC6421160 DOI: 10.2169/internalmedicine.1537-18] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Peripartum cardiomyopathy (PPCM) is rare but life-threatening. We herein report the case of a 48-year-old woman with PPCM after oocyte donation and delivery of twins. Two weeks after delivery, she suffered from severe symptoms of heart failure [orthopnea, New York Heart Association (NYHA) class IV, pulmonary edema and a reduced left ventricular ejection fraction of 18%]. Although standard heart failure therapy was effective for diminishing the congestion, it was not sufficient to improve her symptoms or left ventricular systolic dysfunction. During admission, we added bromocriptine. A year later after the onset, she was in a good state with an improved left ventricular systolic function.
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Affiliation(s)
- Nagisa Morikawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Takaharu Nakayoshi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Hanae Yoshimura
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Megumi Watanabe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Jun Kumanomido
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Aya Furusho
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Daisuke Fukui
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Kazuko Eto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Norifumi Nishida
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Michihide Nishihara
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
| | - Chizuko A Kamiya
- Department of Perinatology and Gynecology, National Cerebral and Cardiovascular Center, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Japan
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Watanabe K, Sakuraya A, Kawakami N, Imamura K, Ando E, Asai Y, Eguchi H, Kobayashi Y, Nishida N, Arima H, Shimazu A, Tsutsumi A. Work-related psychosocial factors and metabolic syndrome onset among workers: a systematic review and meta-analysis. Obes Rev 2018; 19:1557-1568. [PMID: 30047228 DOI: 10.1111/obr.12725] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/14/2018] [Accepted: 05/31/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Work-related psychosocial factors have been associated with metabolic syndrome. However, no systematic reviews or meta-analyses have evaluated this association. METHODS A systematic literature search was conducted, using PubMed, Embase, PsycINFO, PsycARTICLES and the Japan Medical Abstracts Society. Eligible studies included those that examined the previously mentioned association; had a longitudinal or prospective cohort design; were conducted among workers; provided sufficient data for calculating odds ratios, relative risks or hazard ratios with 95% confidence intervals; were original articles in English or Japanese; and were published no later than 2016. Study characteristics, exposure and outcome variables and association measures of studies were extracted by the investigators independently. RESULTS Among 4,664 identified studies, 8 were eligible for review and meta-analysis. The pooled risk of adverse work-related stress on metabolic syndrome onset was significant and positive (RR = 1.47; 95% CI, 1.22-1.78). Sensitivity analyses limiting only the effects of job strain and shift work also indicated a significant positive relationship (RR = 1.75; 95% CI, 1.09-2.79; and RR = 1.59; 95% CI, 1.00-2.54, P = 0.049 respectively). CONCLUSION This study reveals a strong positive association between work-related psychosocial factors and an elevated risk of metabolic syndrome onset. The effects of job strain and shift work on metabolic syndrome appear to be significant.
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Affiliation(s)
- K Watanabe
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - A Sakuraya
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - N Kawakami
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - K Imamura
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - E Ando
- Department of Social and Environmental Health, Division of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Y Asai
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - H Eguchi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara-shi, Kanagawa, Japan
| | | | - N Nishida
- Kyoto Industrial Health Association, Kyoto, Japan
| | - H Arima
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - A Shimazu
- Center for Human and Social Sciences, Kitasato University College of Liberal Arts and Sciences, Sagamihara-shi, Kanagawa, Japan
| | - A Tsutsumi
- Department of Public Health, Kitasato University School of Medicine, Sagamihara-shi, Kanagawa, Japan
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Ohno-Urabe S, Aoki H, Nishihara M, Furusho A, Hirakata S, Nishida N, Ito S, Hayashi M, Hashimoto Y, Majima R, Fukumoto Y. P4418Overactivation of macrophage promotes aortic dissection through the induction of Ink4a/Arf and impairment of smooth muscle proliferation in mouse aorta. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4418] [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)
- S Ohno-Urabe
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - H Aoki
- Cardiovascular Research Institute of the Kurume University, Kurume, Japan
| | - M Nishihara
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - A Furusho
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - S Hirakata
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - N Nishida
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - S Ito
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - M Hayashi
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - Y Hashimoto
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - R Majima
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
| | - Y Fukumoto
- Kurume University School of Medicine, Department of Internal Medicine, Division of Cardiovascular Medicine, Kurume, Japan
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Hirono K, Hata Y, Takarada S, Miyao N, Okabe M, Saito K, Ozawa SW, Nishida N, Ichida F. P2252Cardiomyopathy phenotypes and genotypes for children with left ventricular noncompaction. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2252] [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: 11/13/2022] Open
Affiliation(s)
- K Hirono
- University of Toyama, Department of Pediatrics, Toyama, Japan
| | - Y Hata
- University of Toyama, Department of Legal Medicine, Toyama, Japan
| | - S Takarada
- University of Toyama, Department of Pediatrics, Toyama, Japan
| | - N Miyao
- University of Toyama, Department of Pediatrics, Toyama, Japan
| | - M Okabe
- University of Toyama, Department of Pediatrics, Toyama, Japan
| | - K Saito
- University of Toyama, Department of Pediatrics, Toyama, Japan
| | - S W Ozawa
- University of Toyama, Department of Pediatrics, Toyama, Japan
| | - N Nishida
- University of Toyama, Department of Legal Medicine, Toyama, Japan
| | - F Ichida
- University of Toyama, Department of Pediatrics, Toyama, Japan
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Ito S, Aoki H, Nishihara M, Ohno S, Furusho A, Hirakata S, Nishida N, Hayashi M, Hashimoto Y, Majima R, Kuwahara K, Fukumoto Y. P3779MRTF-A mediates aortic smooth muscle cell apoptosis and inflammatory response to develop aortic dissection. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3779] [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: 11/13/2022] Open
Affiliation(s)
- S Ito
- Kurume University School of Medicine, Kurume, Japan
| | - H Aoki
- Cardiovascular Research Institute of the Kurume University, Kurume, Japan
| | - M Nishihara
- Kurume University School of Medicine, Kurume, Japan
| | - S Ohno
- Kurume University School of Medicine, Kurume, Japan
| | - A Furusho
- Kurume University School of Medicine, Kurume, Japan
| | - S Hirakata
- Kurume University School of Medicine, Kurume, Japan
| | - N Nishida
- Kurume University School of Medicine, Kurume, Japan
| | - M Hayashi
- Kurume University School of Medicine, Kurume, Japan
| | - Y Hashimoto
- Kurume University School of Medicine, Kurume, Japan
| | - R Majima
- Kurume University School of Medicine, Kurume, Japan
| | | | - Y Fukumoto
- Kurume University School of Medicine, Kurume, Japan
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29
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Affiliation(s)
- Ryusuke Ookura
- Department of Diagnostic Radiology, Osaka Saiseikai Nakatsu Hospital, Japan
| | - Go Sakai
- Department of Diagnostic Radiology, Osaka Saiseikai Nakatsu Hospital, Japan
| | - Norifumi Nishida
- Department of Diagnostic Radiology, Osaka Saiseikai Nakatsu Hospital, Japan
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Furusho A, Aoki H, Ohno-Urabe S, Nishihara M, Hirakata S, Nishida N, Ito S, Hayashi M, Imaizumi T, Hiromatsu S, Akashi H, Tanaka H, Fukumoto Y. Involvement of B Cells, Immunoglobulins, and Syk in the Pathogenesis of Abdominal Aortic Aneurysm. J Am Heart Assoc 2018; 7:JAHA.117.007750. [PMID: 29545260 PMCID: PMC5907549 DOI: 10.1161/jaha.117.007750] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background Abdominal aortic aneurysm (AAA) is a potentially life‐threatening disease that is common in older individuals. Currently, therapeutic options are limited to surgical interventions. Although it has long been known that AAA tissue is enriched in B cells and immunoglobulins, their involvement in AAA pathogenesis remains controversial. Methods and Results We investigated the role of B cells and immunoglobulins in a murine model of AAA, induced with a periaortic application of CaCl2, and in human AAA. Both human and mouse AAA tissue showed B‐cell infiltration. Mouse AAA tissue showed deposition of IgG and activation of Syk, a key molecule in B‐cell activation and immunoglobulin function, which were localized to infiltrating cells including B cells and macrophages. B‐cell–deficient muMT mice showed suppression of AAA development that was associated with reduced activation of Syk and less expression of matrix metalloproteinase‐9. Administration of exogenous immunoglobulins restored the blunted Syk activation and AAA development in muMT mice. Additionally, exogenous immunoglobulins induced interleukin‐6 and metalloproteinase‐9 secretions in human AAA tissue cultures. Furthermore, administration of R788, a specific Syk inhibitor, suppressed AAA expansion, reduced inflammatory response, and reduced immunoglobulin deposition in AAA tissue. Conclusions From these results, we concluded that B cells and immunoglobulins participated in AAA pathogenesis by promoting inflammatory and tissue‐destructive activities. Finally, we identified Syk as a potential therapeutic target.
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Affiliation(s)
- Aya Furusho
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hiroki Aoki
- Cardiovascular Research Institute, Kurume University, Kurume, Japan
| | - Satoko Ohno-Urabe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Michihide Nishihara
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Saki Hirakata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Norifumi Nishida
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Sohei Ito
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Makiko Hayashi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | | | - Shinichi Hiromatsu
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hidetoshi Akashi
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hiroyuki Tanaka
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
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Ohno-Urabe S, Aoki H, Nishihara M, Furusho A, Hirakata S, Nishida N, Ito S, Hayashi M, Yasukawa H, Imaizumi T, Akashi H, Tanaka H, Fukumoto Y. Role of Macrophage Socs3 in the Pathogenesis of Aortic Dissection. J Am Heart Assoc 2018; 7:JAHA.117.007389. [PMID: 29343476 PMCID: PMC5850160 DOI: 10.1161/jaha.117.007389] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Aortic dissection (AD) is a life-threatening medical emergency caused by the abrupt destruction of the intimomedial layer of the aortic walls. Given that previous studies have reported the involvement of proinflammatory cytokine interleukin-6 in AD pathogenesis, we investigated the role of signal transduction and activator of transcription 3 signaling, a downstream pathway of interleukin-6 in macrophages in pathogenesis of AD. METHODS AND RESULTS We characterized the pathological and molecular events triggered by aortic stress, which can lead to AD. Aortic stress on the suprarenal aorta because of infrarenal aorta stiffening and angiotensin II infusion for 1 week caused focal medial rupture at the branching point of the celiac trunk and superior mesenteric artery. This focal medial rupture healed in 6 weeks in wild-type (WT) mice, but progressed to AD in mice with macrophage-specific deletion of Socs3 gene (mSocs3-KO). mSocs3-KO mice showed premature activation of cell proliferation, an inflammatory response, and skewed differentiation of macrophages toward the tissue-destructive phenotype. Concomitantly, they showed aberrant phenotypic modulation of smooth muscle cells and transforming growth factor beta signaling, which are likely to participate in tissue repair. Human AD samples revealed signal transduction and activator of transcription 3 activation in adventitial macrophages adjacent to the site of tissue destruction. CONCLUSIONS These findings suggest that AD development is preceded by focal medial rupture, in which macrophage Socs3 maintains proper inflammatory response and differentiation of SMCs, thus promoting fibrotic healing to prevent tissue destruction and AD development. Understanding the sequence of the pathological and molecular events preceding AD development will help predict and prevent AD development and progression.
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Affiliation(s)
- Satoko Ohno-Urabe
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hiroki Aoki
- Cardiovascular Research Institute, Kurume University, Kurume, Japan
| | - Michihide Nishihara
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Aya Furusho
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Saki Hirakata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Norifumi Nishida
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Sohei Ito
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Makiko Hayashi
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hideo Yasukawa
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
| | | | - Hidetoshi Akashi
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hiroyuki Tanaka
- Division of Cardiovascular Surgery, Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshihiro Fukumoto
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan
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Satoh K, Nishida N, Shirabe S. Biomarkers for human prion disease : Results from the creutzfeldt–jakob disease surveillance committee in Japan. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.305] [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: 11/29/2022]
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33
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Nagatomo A, Oguri M, Nishida N, Ogawa M, Ichikawa A, Tanaka-Azuma Y. Evaluation of genotoxicity and subchronic toxicity of standardized rose hip extract. Hum Exp Toxicol 2017; 37:725-741. [DOI: 10.1177/0960327117730881] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Rose hip is the fruit of the rose plant, which is widely used in food, cosmetics and as a traditional medicine. Therefore, rose hip is considered safe and has a sufficient history of consumption as food. However, few studies have reported on the safety of rose hip extracts in toxicological analyses. Thus, to evaluate the safety of rosehip polyphenol MJ (RHPMJ), an aqueous ethanol extract standardized with the trans-tiliroside content, we performed genotoxicity and 90-day repeated oral dose toxicity studies in compliance with the Organisation for Economic Co-operation and Development-Good Laboratory Practice. RHPMJ did not induce gene mutations in reverse mutation tests of Salmonella typhimurium TA98, TA100, TA1535, TA1537 and Escherichia coli WP2 uvrA strains and did not induce chromosomal aberrations in cultured Chinese hamster lung (CHL/IU) cells. Moreover, micronucleus tests using rat bone marrow showed RHPMJ had no micronucleus-inducing potential. Finally, 90-day repeated oral dose toxicity studies (100–1000 mg/kg) in male and female rats showed no treatment-related toxicity in rats. These data indicate that the RHPMJ had no genotoxicity and a no-observed-adverse-effect level greater than 1000 mg/kg in rats.
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Affiliation(s)
| | - M Oguri
- Morishita Jintan Co., Ltd, Osaka, Japan
| | - N Nishida
- Morishita Jintan Co., Ltd, Osaka, Japan
| | - M Ogawa
- Bioresearch Center, CMIC Pharma Science Co., Ltd, Yamanashi, Japan
| | - A Ichikawa
- Bioresearch Center, CMIC Pharma Science Co., Ltd, Yamanashi, Japan
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Ohno S, Aoki H, Nishihara M, Furusho A, Hirakata S, Nishida N, Ito S, Hayashi M, Akashi H, Tanaka H, Fukumoto Y. P690Macrophage Stat3 promotes progression of aortic dissection via M1 differentiation and smooth muscle dedifferentiation. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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35
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Nishida N, Aoki H, Ohno S, Nishihara M, Furusho A, Hirakata S, Hayashi M, Ito S, Yasukawa H, Fukumoto Y. P5396Synergistic effect of high salt and IL-17 worsens aortic dissection by dysregulation of extracellular matrix. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p5396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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36
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Ito S, Aoki H, Nishihara M, Ohno S, Furusho A, Hirakata S, Nishida N, Hayashi M, Fukumoto Y. 3851Myocardin-related transcription factor-A is required for development of aortic dissection. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.3851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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37
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Furusho A, Aoki H, Nishihara M, Ohno S, Hirakata S, Nishida N, Ito S, Hayashi M, Akashi H, Tanaka H, Fukumoto Y. 3849Involvement of B cell/Syk axis in development of abdominal aortic aneurysm. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.3849] [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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38
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Yokobori T, Suzuki S, Miyazaki T, Sohda M, Sakai M, Tanaka N, Ozawa D, Hara K, Honjo H, Altan B, Fukuchi M, Ishii H, Iwatsuki M, Sugimachi K, Sudo T, Iwaya T, Nishida N, Mimori K, Kuwano H, Mori M. Intestinal epithelial culture under an air-liquid interface: a tool for studying human and mouse esophagi. Dis Esophagus 2016; 29:843-847. [PMID: 25809505 DOI: 10.1111/dote.12346] [Citation(s) in RCA: 4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
This study investigated whether an intestinal epithelial culture method can be applied to mouse and human esophageal cultures. The esophagi harvested from 1-day-old mice and adult humans were maintained in collagen gels. A commercially available culture medium for human embryonic stem cells was used for the human esophageal culture. We discovered that the intestinal epithelial culture method can be successfully applied to both mouse and human esophageal cultures. The long-term cultured esophageal organoids were rod-like luminal structures lined with myofibroblasts. We discovered that regeneration of the esophageal mucosal surface can be almost completely achieved in vitro, and the advantage of this method is that organoid cultures may be generated using host-derived fibroblasts as a niche. This method is a promising tool for mouse and human research in intestinal biology, carcinogenesis, and regenerative medicine.
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Affiliation(s)
- T Yokobori
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - S Suzuki
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - T Miyazaki
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - M Sohda
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - M Sakai
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - N Tanaka
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - D Ozawa
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - K Hara
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - H Honjo
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - B Altan
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - M Fukuchi
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - H Ishii
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - M Iwatsuki
- Department of Surgery, Medical Institute of Bioregulation, Kyushu University, Beppu, Japan
| | - K Sugimachi
- Department of Surgery, Medical Institute of Bioregulation, Kyushu University, Beppu, Japan
| | - T Sudo
- Department of Surgery, Medical Institute of Bioregulation, Kyushu University, Beppu, Japan
| | - T Iwaya
- Department of Surgery, Medical Institute of Bioregulation, Kyushu University, Beppu, Japan
| | - N Nishida
- Department of Surgery, Medical Institute of Bioregulation, Kyushu University, Beppu, Japan
| | - K Mimori
- Department of Surgery, Medical Institute of Bioregulation, Kyushu University, Beppu, Japan
| | - H Kuwano
- Department of General Surgical Science, Graduate School of Medicine, Gunma University, Maebashi, Japan
| | - M Mori
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Japan.
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Kishi K, Mitsuzane K, Sonomura T, Nishida N, Sato M, Yamada R. Dacron-Covered Stent Therapy for Portal Vein Tumor Thrombus in Hepatocellular Carcinoma. Acta Radiol 2016. [DOI: 10.1177/028418519303400313] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A tumor thrombus of the portal vein is refractory to therapy and constitutes a serious prognostic factor in hepatocellular carcinoma. For the purpose of treating portal vein tumor thrombus by restoring the blood flow and preventing recurrent ingrowth of tumor, we devised a metallic stent partially covered with a Dacron mesh sheet, and a coaxial percutaneous delivery system. One half of the wall of a Gianturco Z-stent was covered with a sheet of 0.25-mm-thick Dacron mesh, fixed to the stent wall with nylon threads. The covered stent was implanted in a patient with severe main portal vein stenosis due to tumor thrombus protruding from the left portal vein branch. Immediately after stent placement the tumor stenosis was effectively dilated, the portal blood flow restored, and the portal hypertension relieved. CT and angiography after 8 months still showed complete portal vein patency. Intrahepatic tumor dissemination or other complications were not observed. Intraportal placement of a covered metallic stent appears to be an efficacious therapy of major portal tumor thrombi.
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Yamamoto A, Nishida N, Morikawa H, Jogo A, Kageyama K, Sohgawa E, Hamamoto S, Takeshita T, Sakai Y, Matsuoka T, Kawada N, Miki Y. Prediction for Improvement of Liver Function after Balloon-Occluded Retrograde Transvenous Obliteration for Gastric Varices to Manage Portosystemic Shunt Syndrome. J Vasc Interv Radiol 2016; 27:1160-7. [PMID: 27234486 DOI: 10.1016/j.jvir.2016.03.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 03/12/2016] [Accepted: 03/15/2016] [Indexed: 12/18/2022] Open
Abstract
PURPOSE To investigate predictive factors and cutoff value of transient elastography (TE) measurements for assessing improvement in liver function after balloon-occluded retrograde transvenous obliteration (BRTO) for gastric varices (GV). MATERIALS AND METHODS Retrospective analysis was performed of 50 consecutive patients followed for > 3 months after BRTO, who had undergone TE before BRTO between January 2011 and February 2015. The correlation between change in liver function (total bilirubin, albumin, and prothrombin time) and baseline liver function values and liver stiffness measurement (LSM) by TE was evaluated by Pearson correlation test. Receiver operating characteristic curves were used to determine cutoff values for discriminating between patients who had improved liver function and patients who did not. The time interval from BRTO to aggravation of esophageal varices (EV) (worsening morphology, development of new varices, or variceal rupture) grouped by cutoff values was also analyzed. RESULTS Serum albumin was significantly improved at 3 months after BRTO (3.57 g/dL vs 3.74 g/dL, P < .001). There was a significant negative correlation between change in albumin and baseline LSM (r = -0.50, P < .001). The best cutoff point for LSM was ≤ 22.9 kPa, with sensitivity and specificity of 78.4% and 69.2%, respectively, for predicting which patients would have improved albumin after BRTO. Among 33 patients, 29 (88%) patients had improved albumin. The 1-year progression rate of EV after BRTO was 13.6% in patients with LSM ≤ 22.9 kPa. CONCLUSIONS The predictive factor for improvement in albumin after BRTO was lower LSM (≤ 22.9 kPa) using TE.
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Affiliation(s)
- Akira Yamamoto
- Departments of Radiology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Norifumi Nishida
- Departments of Radiology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
| | - Hiroyasu Morikawa
- Premier Preventive Medicine, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Atsushi Jogo
- Departments of Radiology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Ken Kageyama
- Departments of Radiology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Etsuji Sohgawa
- Departments of Radiology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Shinichi Hamamoto
- Departments of Radiology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Toru Takeshita
- Departments of Radiology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Yukimasa Sakai
- Departments of Radiology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Toshiyuki Matsuoka
- Departments of Radiology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Norifumi Kawada
- Hepatology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
| | - Yukio Miki
- Departments of Radiology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan
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Okazaki E, Yamamoto A, Nishida N, Hamuro M, Ogino R, Hosono M, Shimatani Y, Tsutsumi S, Hamamoto S, Sohgawa E, Jogo A, Miki Y. Three-dimensional conformal radiotherapy for locally advanced hepatocellular carcinoma with portal vein tumour thrombosis: evaluating effectiveness of the model for end-stage liver disease (MELD) score compared with the Child-Pugh classification. Br J Radiol 2016; 89:20150945. [PMID: 27164029 DOI: 10.1259/bjr.20150945] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE The purpose of this study was to retrospectively evaluate the effectiveness of the model for end-stage liver disease (MELD) score compared with the Child-Pugh classification in patients who received three-dimensional conformal radiotherapy (3D CRT) for hepatocellular carcinoma (HCC) with portal vein tumour thrombosis (PVTT) by analyzing toxicity and prognostic factors. METHODS 56 consecutive patients who had locally advanced HCC with PVTT treated by 3D CRT between September 2007 and April 2013 were retrospectively reviewed. RESULTS The median survival time of all patients was 6.4 months. Receiver-operating characteristic (ROC) analysis identified MELD score = 7.5 [area under the curve (AUC) 0.81] and Child-Pugh score = 6.5 (AUC 0.86) as the best cut-off values for predicting the incidence of complications over Common Terminology Criteria for Adverse Events grade 2. There was no significant difference in the discrimination power between the MELD score and the Child-Pugh score on comparison of the two ROC curves (p = 0.17). On multivariate analysis, age, MELD score and radiotherapy dose were significant prognostic factors for overall survival (p = 0.021, 0.038 and 0.006, respectively). In contrast, the Child-Pugh classification, tumour response, PVTT response and the number of prior interventional radiologic treatments were not significant on multivariate analysis. CONCLUSION This study showed that the best MELD score cut-off value is 7.5 and that the MELD score is a better prognostic factor than the Child-Pugh classification in 3D CRT for HCC with PVTT. ADVANCES IN KNOWLEDGE The MELD score is useful for predicting the risk of severe toxicities and the prognosis of patients treated with 3D CRT for PVTT.
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Affiliation(s)
- Eiichiro Okazaki
- 1 Department of Diagnostic and Interventional Radiology/Radiation Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Akira Yamamoto
- 1 Department of Diagnostic and Interventional Radiology/Radiation Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Norifumi Nishida
- 2 Department of Radiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan
| | - Masao Hamuro
- 1 Department of Diagnostic and Interventional Radiology/Radiation Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Ryo Ogino
- 3 Department of Radiation Oncology, Tane General Hospital, Osaka, Japan
| | - Masako Hosono
- 1 Department of Diagnostic and Interventional Radiology/Radiation Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yasuhiko Shimatani
- 1 Department of Diagnostic and Interventional Radiology/Radiation Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shinichi Tsutsumi
- 1 Department of Diagnostic and Interventional Radiology/Radiation Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Shinichi Hamamoto
- 1 Department of Diagnostic and Interventional Radiology/Radiation Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Etsuji Sohgawa
- 1 Department of Diagnostic and Interventional Radiology/Radiation Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Atsushi Jogo
- 1 Department of Diagnostic and Interventional Radiology/Radiation Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yukio Miki
- 1 Department of Diagnostic and Interventional Radiology/Radiation Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
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Funaba M, Kanchiku T, Imajo Y, Suzuki H, Yoshida Y, Nishida N, Fujimoto K, Taguchi T. Characteristics of C6-7 myelopathy: assessment of clinical symptoms and electrophysiological findings. Spinal Cord 2015; 54:798-803. [PMID: 26572604 DOI: 10.1038/sc.2015.203] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 10/04/2015] [Accepted: 10/13/2015] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN This is a single-center retrospective study. OBJECTIVES The objective of this study was to study the clinical symptoms and electrophysiological features of C6-7 myelopathy. SETTING This study was conducted at the Department of Orthopedic surgery, Yamaguchi University Graduate school of medicine, Japan. METHODS A total of 20 patients with cervical compressive myelopathy were determined by spinal cord-evoked potentials or a single level of obvious magnetic resonance imaging (MRI)-documented cervical spinal cord compression. Neurological examinations included manual muscle testing and investigation of deep tendon reflex, including Hoffmann sign, and of sensory disturbance areas. Motor-evoked potentials (MEPs), compound muscle action potentials (CMAPs) and F-wave were recorded from bilateral abductor digit minim and abductor halluces muscles. Central motor conduction time was calculated as follows: MEPs latency-(CMAPs latency+F latency-1)/2 (ms). RESULTS Eighteen patients (90%) had negative Hoffmann sign. Eight patients (40%) had no sensory disturbance in the upper limbs and 8 patients (40%) had no muscle weakness in the upper limbs. We determined that patients had cervical myelopathy when their central motor conduction time measured in abductor digit minim was longer than 6.76 ms (+2 s.d.). Using this definition, the sensitivity for myelopathy was 42.8%. CONCLUSION Patients with C6-7 myelopathy may lack clinical symptoms in their hands and central motor conduction time measured in abductor digit minim tended to be less prolonged, and it only showed symptoms in their lower limbs as gait disturbance. Surgeons should bear in mind the possibility of disorders of caudal C6-7 when they encounter patients with no or few symptoms in their hands and with leg weakness or numbness.
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Affiliation(s)
- M Funaba
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube city, Japan
| | - T Kanchiku
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube city, Japan
| | - Y Imajo
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube city, Japan
| | - H Suzuki
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube city, Japan
| | - Y Yoshida
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube city, Japan
| | - N Nishida
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube city, Japan
| | - K Fujimoto
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube city, Japan
| | - T Taguchi
- Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube city, Japan
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Suetomi Y, Kanchiku T, Nishijima S, Imajo Y, Suzuki H, Yoshida Y, Nishida N, Taguchi T. Application of diffusion tensor imaging for the diagnosis of segmental level of dysfunction in cervical spondylotic myelopathy. Spinal Cord 2015; 54:390-5. [DOI: 10.1038/sc.2015.192] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 07/01/2015] [Accepted: 09/16/2015] [Indexed: 11/09/2022]
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Nishida N, Ohashi J, Sugiyama M, Tsuchiura T, Yamamoto K, Hino K, Honda M, Kaneko S, Yatsuhashi H, Koike K, Yokosuka O, Tanaka E, Taketomi A, Kurosaki M, Izumi N, Sakamoto N, Eguchi Y, Sasazuki T, Tokunaga K, Mizokami M. Effects of HLA-DPB1 genotypes on chronic hepatitis B infection in Japanese individuals. ACTA ACUST UNITED AC 2015; 86:406-12. [PMID: 26449183 DOI: 10.1111/tan.12684] [Citation(s) in RCA: 9] [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: 07/07/2015] [Revised: 09/04/2015] [Accepted: 09/15/2015] [Indexed: 01/26/2023]
Abstract
Significant associations of HLA-DP alleles with chronic hepatitis B (CHB) infection are evident in Asian and Arabian populations, including Japanese, Han Chinese, Korean, and Saudi Arabian populations. Here, significant associations between CHB infection and five DPB1 alleles (two susceptibility alleles, DPB1(*) 05:01 and (*) 09:01, and three protective alleles, DPB1(*) 02:01, (*) 04:01, and (*) 04:02) were confirmed in a population comprising of 2582 Japanese individuals. Furthermore, odds ratios for CHB were higher for those with both DPB1 susceptibility alleles than for those with only one susceptibility allele; therefore, effects of susceptibility alleles were additive for risk of CHB infection. Similarly, protective alleles showed an additive effect on protection from CHB infection. Moreover, heterozygotes of any protective allele showed stronger association with CHB than did homozygotes, suggesting that heterozygotes may bind a greater variety of hepatitis B-derived peptides, and thus present these peptides more efficiently to T-cell receptors than homozygotes. Notably, compound heterozygote of the protective allele (any one of DPB1*02:01, *04:01, and *04:02) and the susceptible allele DPB1*05:01 was significantly associated with protection against CHB infection, which indicates that one protective HLA-DPB1 molecule can provide dominant protection. Identification of the HLA-DPB1 genotypes associated with susceptibility to and protection from CHB infection is essential for future analysis of the mechanisms responsible for immune recognition of hepatitis B virus antigens by HLA-DPB1 molecules.
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Affiliation(s)
- N Nishida
- Department of Hepatic Disease, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan.,Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - J Ohashi
- Department of Biological Sciences, Graduate School of Science, The University of Tokyo, Tokyo, Japan
| | - M Sugiyama
- Department of Hepatic Disease, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan
| | - T Tsuchiura
- Department of Hepatic Disease, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan
| | - K Yamamoto
- Department of Medical Chemistry, Kurume University School of Medicine, Kurume, Japan
| | - K Hino
- Department of Hepatology and Pancreatology, Kawasaki Medical School, Kurashiki, Japan
| | - M Honda
- Department of Gastroenterology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - S Kaneko
- Department of Gastroenterology, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - H Yatsuhashi
- Clinical Research Center, National Nagasaki Medical Center, Nagasaki, Japan
| | - K Koike
- Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - O Yokosuka
- Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - E Tanaka
- Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan
| | - A Taketomi
- Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - M Kurosaki
- Division of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
| | - N Izumi
- Division of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan
| | - N Sakamoto
- Department of Gastroenterology and Hepatology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Y Eguchi
- Division of Hepatology, Saga Medical School, Saga, Japan
| | - T Sasazuki
- Institute for Advanced Study, Kyushu University, Fukuoka, Japan
| | - K Tokunaga
- Department of Human Genetics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - M Mizokami
- Department of Hepatic Disease, The Research Center for Hepatitis and Immunology, National Center for Global Health and Medicine, Chiba, Japan
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Ota T, Tsukuda H, Tokunaga M, Nishida N, Hasegawa Y, Suzumura T, Fukuoka M. Catheter detachment. Oxf Med Case Reports 2015; 2015:292-3. [PMID: 26504585 PMCID: PMC4617418 DOI: 10.1093/omcr/omv038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 04/26/2015] [Indexed: 11/14/2022] Open
Affiliation(s)
- Takayo Ota
- Department of Medical Oncology, Izumi Municipal Hospital, Izumi, Osaka, Japan
- Correspondence address. Department of Medical Oncology, Izumi Municipal Hospital, Izumi, Osaka 594-0071, Japan. Tel: +81-725-41-1331; Fax: +81-725-43-3350; E-mail:
| | - Hiroshi Tsukuda
- Department of Medical Oncology, Izumi Municipal Hospital, Izumi, Osaka, Japan
| | - Masahiro Tokunaga
- Department of Radiology, Izumi Municipal Hospital, Izumi, Osaka, Japan
| | - Norifumi Nishida
- Department of Diagnostic and Interventional Radiology, Osaka City Medical University, Osaka, Japan
| | - Yoshikazu Hasegawa
- Department of Medical Oncology, Izumi Municipal Hospital, Izumi, Osaka, Japan
| | - Tomohiro Suzumura
- Department of Medical Oncology, Izumi Municipal Hospital, Izumi, Osaka, Japan
| | - Masahiro Fukuoka
- Department of Medical Oncology, Izumi Municipal Hospital, Izumi, Osaka, Japan
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Nishida N, Yang X, Takasaki I, Imai K, Kato K, Inoue Y, Imamura T, Miyashita R, Kato F, Yamaide A, Mori M, Saito S, Hara J, Adachi Y, Miyawaki T, Kanegane H. Dysgammaglobulinemia Associated With Glu349del, a Hypomorphic XIAP Mutation. J Investig Allergol Clin Immunol 2015; 25:205-213. [PMID: 26182687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND X-linked lymphoproliferative syndrome type 2 is a rare hereditary immunodeficiency caused by mutations in the XIAP gene. This immunodeficiency frequently results in hemophagocytic lymphohistiocytosis, although hypogammaglobulinemia and dysgammaglobulinemia are also common. OBJECTIVE We identified 17 patients from 12 Japanese families with mutations in XIAP. The Glu349del mutation was observed in 3 patients, each from a different family. Interestingly, these patients exhibited dysgammaglobulinemia but not hemophagocytic lymphohistiocytosis. We conducted an immunological study of patients carrying Glu349del and other mutations to elucidate the pathogenic mechanisms of dysgammaglobulinemia in patients with mutations in the XIAP gene. PATIENTS AND METHODS We performed an immunological study of 2 patients carrying the Glu349del mutation and 8 patients with other mutations. RESULTS Flow cytometry showed that the percentage of memory B cells in patients with a mutation in XIAP was lower than that observed in the healthy controls. The patients with the Glu349del mutation had a lower percentage of memory B cells than those with other mutations. Ig production was reduced in patients with the Glu349del mutation. Increased susceptibility to apoptosis was observed in the patients with other mutations. Susceptibility to apoptosis was normal in patients with Glu349del. Microarray analysis indicated that expression of Ig-related genes was reduced in patients with the Glu349del mutation and that the pattern was different from that observed in the healthy controls or patients with other mutations in XIAP. CONCLUSIONS Patients carrying the Glu349del mutation in the XIAP gene may have a clinically and immunologically distinct phenotype from patients with other XIAP mutations. The Glu349del mutation may be associated with dysgammaglobulinemia.
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Takaki H, Yamakado K, Tsurusaki M, Yasumoto T, Baba Y, Narimatsu Y, Shimohira M, Yamaguchi M, Matsuo K, Inaba Y, Mikami K, Watanabe R, Nishida N, Anai H, Kakizawa H, Hirota S. Hepatic arterial infusion chemotherapy with fine-powder cisplatin and iodized-oil suspension in patients with intermediate-stage and advanced-stage (Barcelona Clinic Liver Cancer stage-B or stage-C) hepatocellular carcinoma: multicenter phase-II clinical study. Int J Clin Oncol 2014; 20:745-54. [PMID: 25432660 DOI: 10.1007/s10147-014-0773-4] [Citation(s) in RCA: 10] [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] [Subscribe] [Scholar Register] [Received: 08/21/2014] [Accepted: 11/16/2014] [Indexed: 02/07/2023]
Abstract
PURPOSE This single-arm, multicenter, phase-II trial evaluated the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) using fine-powder cisplatin and iodized-oil suspension in patients with intermediate- and advanced-stage [Barcelona Clinic Liver Cancer (BCLC) stage-B and stage-C] hepatocellular carcinomas (HCCs). METHODS The Institutional Review Board approved this study and patients provided written informed consent. Thirty-five patients (24 men and 11 women, mean 74 ± 6 years [range 60-87 years]) with BCLC stage-B (57 %, 20/35) or stage-C (43 %, 15/35) HCCs who were not candidates for other locoregional treatments were enrolled. HAIC was performed using a suspension of fine-powder cisplatin with a maximum dose of 65 mg/m(2) and iodized oil on demand. The primary endpoint was the response rate evaluated based on Response Evaluation Criteria in Solid Tumor (RECIST) and modified RECIST (mRECIST). Secondary endpoints were overall survival, progression-free survival, and safety. RESULTS The initial and best overall response rates at 4 weeks and 3 months, respectively, were 14 and 17 % based on RECIST, and 57 and 23 % based on mRECIST. The median overall and progression-free survival times were 18 and 4 months, respectively. The most frequent grade-3 or grade-4 adverse events were elevation of serum alanine (23 %) and aspartate aminotransferase (20 %), and thrombocytopenia (17 %). CONCLUSION This HAIC provides promising therapeutic effects with acceptable safety to patients with intermediate-stage and advanced-stage HCCs.
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Affiliation(s)
- Haruyuki Takaki
- Department of Radiology, Mie University School of Medicine, Mie, Japan,
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Ichiki M, Nishida N, Furukawa A, Kanasaki S, Ohta S, Miki Y. Imaging findings of primary hepatic carcinoid tumor with an emphasis on MR imaging: case study. Springerplus 2014; 3:607. [PMID: 25392779 PMCID: PMC4210452 DOI: 10.1186/2193-1801-3-607] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 10/09/2014] [Indexed: 12/20/2022]
Abstract
Carcinoid tumors are slow-growing tumors originating in the neuroendocrine cells, and occur most frequently within the gastrointestinal tract. Although the liver is the most common site for metastatic carcinoid tumors, primary hepatic carcinoid tumors are exceedingly rare and reports of the imaging findings have been very scarce. We herein report imaging findings with an emphasis on magnetic resonance imaging in two cases of primary hepatic carcinoid tumors. In both cases, the tumors showed cystic areas with hemorrhagic components and early enhanced solid areas.
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Affiliation(s)
- Makoto Ichiki
- Department of Radiology, Osaka City General Hospital, 2-13-22 Miyakojima-hondori, Miyakojima-ku, Osaka, Japan
| | - Norifumi Nishida
- Department of Radiology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, Japan
| | - Akira Furukawa
- Department of Radiological Sciences, Tokyo Metropolitan University, 1-1 Minami-Osawa, Hachioji-shi, Tokyo, Japan
| | - Shuzo Kanasaki
- Department of Radiology, Koseikai Takeda Hospital, 841-5 Higashishiokoji-cho, Shiokojidori Nishinotoin Higashi-iru, Shimogyo-ku, Kyoto, Japan
| | - Shinichi Ohta
- Department of Radiology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga, Japan
| | - Yukio Miki
- Department of Radiology, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka, Japan
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Colvin HS, Nishida N, Koseki J, Konno M, Kawamoto K, Tsunekuni K, Doki Y, Mori M, Ishii H. Cancer Stem Cells of the Digestive System. Jpn J Clin Oncol 2014; 44:1141-9. [DOI: 10.1093/jjco/hyu146] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
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