135 results on '"Takahata H"'
Search Results
2. Impact of low pharyngeal/esophageal pressure associated with sarcopenia on postendoscopic submucosal dissection pneumonia in patients with superficial esophageal cancer.
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Taniguchi Y, Ono J, Haraguchi M, Tabuchi M, Hisamatsu N, Takahata H, Kondo H, Yamaguchi N, Kumai Y, and Nakao K
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- Humans, Male, Female, Aged, Middle Aged, Pressure, Deglutition Disorders etiology, Pneumonia etiology, Pharynx surgery, Aged, 80 and over, Esophagus surgery, Esophagus physiopathology, Endoscopic Mucosal Resection adverse effects, Sarcopenia complications, Sarcopenia etiology, Esophageal Neoplasms surgery, Esophageal Neoplasms complications, Postoperative Complications etiology, Manometry
- Abstract
Objectives: The aging population, including patients with superficial esophageal cancer, encounters critical dysphagia- and postoperative pneumonia-related issues. Although endoscopic submucosal dissection (ESD) provides advantages over other modalities, older patients are at higher risk of postoperative pneumonia. Furthermore, the etiologies of pneumonia are complex and include patient- (such as sarcopenia) and treatment- (including ESD) related factors. Therefore, this study evaluated swallowing function in patients with superficial esophageal cancer and identified post-ESD pneumonia-associated factors., Methods: Comprehensive swallowing function and sarcopenia were evaluated in patients pre-ESD and 2 months post-ESD using high-resolution manometry and several swallowing studies by multiple experts. The effects of mucosal resection and sarcopenia on swallowing function changes post-ESD, the relationship between preoperative swallowing function and sarcopenia, and the factors influencing postoperative pneumonia were investigated., Results: Twenty patients were included in the study. Patients with preoperative sarcopenia had significantly lower pharyngeal/upper esophageal sphincter and tongue pressures than those without sarcopenia. However, ESD did not worsen pharyngeal or upper esophageal pressure. Post-ESD pneumonia incidence tended to be higher in patients with sarcopenia than in those without sarcopenia. The lower upper esophageal sphincter-integrated relaxation pressure (UES-IRP) was a significant factor in pneumonia development. Furthermore, the receiver operating characteristic curve for UES-IRP in pneumonia yielded an area under the curve of 0.82., Conclusions: Sarcopenia is associated with preoperative dysphagia, which increases post-ESD pneumonia risk. Therefore, postoperative pneumonia incidence is expected to increase with an aging population, making preoperative sarcopenia and swallowing function evaluation crucial., (© 2023 Japan Gastroenterological Endoscopy Society.)
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- 2024
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3. Association Between Disease Severity and Frailty in Patients with Aortic Stenosis.
- Author
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Tanaka Y, Yano Y, Watanabe T, Yonekura T, Motokawa T, Takahata H, Maemura K, and Kozu R
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- Humans, Male, Female, Retrospective Studies, Aged, Aged, 80 and over, Transcatheter Aortic Valve Replacement, Geriatric Assessment methods, Walking Speed, Prevalence, Aortic Valve Stenosis complications, Aortic Valve Stenosis surgery, Aortic Valve Stenosis epidemiology, Frailty epidemiology, Frailty complications, Severity of Illness Index, Natriuretic Peptide, Brain blood, Peptide Fragments blood
- Abstract
Frailty is highly prevalent among patients with aortic stenosis (AS). Nonetheless, the impact of AS severity on frailty remains unclear. This study aimed to clarify the association between AS severity and frailty in this population.This retrospective study included consecutive patients with AS who were hospitalized as candidates for transcatheter aortic valve implantation (TAVI). The prevalence of frailty, N-terminal pro B-type natriuretic peptide (NT-proBNP) level, gait speed, and geriatric nutritional risk index (GNRI) were compared between patients with severe and those with very severe AS. We employed multiple logistic regression analysis to examine the association between AS severity and frailty.A total of 137 patients were included. The prevalence of frailty was not significantly different between the severe and very severe AS groups (31% versus 30%). Similarly, no significant differences between the groups were observed for gait speed and GNRI, whereas the NT-proBNP level was significantly higher in the very severe group than in the severe AS group (P < 0.01). In the multiple logistic regression analysis, AS severity was not associated with frailty; however, gait speed and GNRI showed significant association with frailty independently of age, sex, and heart failure (very severe AS: odds ratio [OR] 1.051, 95% confidence interval [CI] 0.439-2.517; low gait speed: OR 5.109, 95% CI 1.556-16.775; malnutrition: OR 2.841, 95% CI 1.145-7.049).These findings suggest that low-intensity exercise training and nutritional therapy may be necessary in addition to AS treatment for the management of frailty in this population.
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- 2024
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4. Benign Mesothelial Cells in transbronchial biopsy specimens: A potential diagnostic pitfall for lung cancer.
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Sugihara T, Teramoto N, Shigematsu H, Nakashima S, Ryuko T, Ueno T, Suehisa H, Abe C, Takahata H, Kato Y, Ninomiya T, Harada D, Kozuki T, and Yamashita M
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- Humans, Lung pathology, Retrospective Studies, Biopsy methods, Lung Neoplasms diagnosis, Lung Neoplasms pathology, Lung Diseases pathology
- Abstract
Bronchoscopy is a common diagnostic procedure used to identify lung cancer. Specimens acquired through transbronchial biopsy are pivotal in the diagnosis and molecular characterization of this disease. The occurrence of benign mesothelial cells during a transbronchial biopsy (TBB) is relatively rare. Furthermore, these lesions can sometimes be erroneously identified as malignant, potentially resulting in unwarranted or inappropriate treatment for patients with and without lung cancer. In this retrospective analysis, we examined 619 TBB cases at our institute from 2019 to 2021. Benign mesothelial cells were identified via immunohistochemical studies in eight (1.3%) of 619 cases. These cells were classified into three patterns based on their cellular morphology: monolayer, lace, and cobblestone. Recognizing this phenomenon during the procedure is crucial to accurately distinguish benign mesothelial cells from their cancerous counterparts., (Copyright © 2023 Elsevier GmbH. All rights reserved.)
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- 2024
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5. Multiple benign notochordal cell tumors in lung with cystic change.
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Kobayashi Y, Sugawara Y, Takahata H, Shimizu T, Teramoto N, Ueno T, and Ninomiya T
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Benign notochordal cell tumor (BNCT) is a benign lesion derived from notochordal cells. Although it is relatively common in intraosseous lesion, pulmonary BNCT is extremely rare. We present a case of 54-year-old male with multiple pulmonary nodules, in which were considered to be metastatic chordomas initially. For 20 months follow-up without any therapy, most of the nodules had no remarkable change but some nodules showed cystic change. We consulted with pathologists specializing in chordoma and the final diagnosis of the nodules was considered as BNCT rather than chordoma. We herein report the case of multiple pulmonary BNCTs with cystic change, comparing with previous reports., (© 2023 The Authors. Published by Elsevier Inc. on behalf of University of Washington.)
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- 2023
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6. Urinary titin N-fragment as a predictor of decreased skeletal muscle mass in patients with interstitial lung diseases.
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Hanada M, Ishimatsu Y, Sakamoto N, Akiyama Y, Kido T, Ishimoto H, Oikawa M, Nagura H, Takeuchi R, Sato S, Takahata H, Mukae H, and Kozu R
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- Humans, Biomarkers urine, Connectin urine, Muscle, Skeletal, Retrospective Studies, Lung Diseases, Interstitial
- Abstract
This study aimed to examine the validity of urinary N-terminal titin fragment/creatinine (urinary N-titin/Cr) reflecting muscle damage biomarker in patients with interstitial lung disease. This retrospective study enrolled patients with interstitial lung disease. We measured urinary N-titin/Cr. Furthermore, we measured the cross-sectional areas of the pectoralis muscles above the aortic arch (PM
CSA ) and erector spinae muscles of the 12th thoracic vertebra muscles (ESMCSA ) to assess muscle mass until 1 year. We examined the correlation between urinary N-titin/Cr and the change in muscle mass. We plotted receiver operating characteristic curves to estimate the cut-off points for urinary N-titin/Cr for distinguishing the greater-than-median and smaller-than-median reduction of muscle mass after 1 year. We enrolled 68 patients with interstitial lung disease. The median urinary N-titin/Cr value was 7.0 pmol/mg/dL. We observed significant negative correlations between urinary N-titin/Cr and changes in the PMCSA after 1 year (p < 0.001) and changes in the ESMCSA after 6 months (p < 0.001) and 1 year (p < 0.001). The cut-off points for urinary N-titin/Cr were 5.2 pmol/mg/dL and 10.4 pmol/mg/dL in the PMCSA and ESMCSA , respectively. In summary, urinary N-titin/Cr may predict muscle loss in the long-term and act as a clinically useful biomarker reflecting muscle damage., (© 2023. The Author(s).)- Published
- 2023
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7. Association between hospital acquired disability and post-discharge mortality in patients after living donor liver transplantation.
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Hanada M, Hidaka M, Soyama A, Tanaka T, Hara T, Matsushima H, Haraguchi M, Kitamura M, Sekino M, Oikawa M, Nagura H, Takeuchi R, Sato S, Takahata H, Eguchi S, and Kozu R
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- Humans, Living Donors, Patient Discharge, Retrospective Studies, Activities of Daily Living, Aftercare, Liver Transplantation
- Abstract
Background: Hospital-acquired disability (HAD) in patients who undergo living donor liver transplantation (LDLT) is expected to worsen physical functions due to inactivity during hospitalization. The aim of this study was to explore whether a decline in activities of daily living from hospital admission to discharge is associated with prognosis in LDLT patients, who once discharged from a hospital., Methods: We retrospectively examined the relationship between HAD and prognosis in 135 patients who underwent LDLT from June 2008 to June 2018, and discharged from hospital once. HAD was defined as a decline of over 5 points in the Barthel Index as an activity of daily living assessment. Additionally, LDLT patients were classified into four groups: low or high skeletal muscle index (SMI) and HAD or non-HAD. Univariate and multivariate Cox proportional hazard models were used to evaluate the association between HAD and survival., Results: HAD was identified in 47 LDLT patients (34.8%). The HAD group had a significantly higher all-cause mortality than the non-HAD group (log-rank: p < 0.001), and in the HAD/low SMI group, all-cause mortality was highest between the groups (log-rank: p < 0.001). In multivariable analysis, HAD was an independent risk factor for all-cause mortality (hazard ratio [HR]: 16.54; P < 0.001) and HAD/low SMI group (HR: 16.82; P = 0.002)., Conclusion: HAD was identified as an independent risk factor for all-cause mortality suggesting that it could be a key component in determining prognosis after LDLT. Future larger-scale studies are needed to consider the overall new strategy of perioperative rehabilitation, including enhancement of preoperative physiotherapy programs to improve physical function., (© 2022. The Author(s).)
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- 2022
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8. Surveillance and risk assessment of health screening for vaccine-preventable diseases among international students in Japan: A cross-sectional study in 2020.
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Takahata H, Onishi K, Nomoto H, Iwamoto N, Hayashi K, Hori N, Kutsuna S, Kodama EN, and Ohmagari N
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- Humans, Cross-Sectional Studies, Vaccination, Risk Assessment, Japan epidemiology, Vaccine-Preventable Diseases prevention & control, Chickenpox prevention & control, Tuberculosis, Measles prevention & control, Rubella prevention & control, Mumps prevention & control
- Abstract
We conducted a cross-sectional study using a structured questionnaire in three major Japanese cities from August 03 to 24, 2020 to clarify the current situation of health checkups, including vaccine-preventable diseases (VPDs), among international students at Japanese universities (JUs) and Japanese language schools (JLSs). The total response rate was 36%: 69 JUs (31%) and 137 JLSs (39%). Over 90% of these institutions conducted chest X-ray screening for tuberculosis among their students, whereas only 24.6% of JUs and 15.3% of JLSs performed general blood tests for health screening. Only 14.5% and 2.2% of the JUs and JLSs, respectively, required the submission of vaccination or antibody certificates for admission. The difficulties in requesting vaccination certificates from international students are due to poor legal requirements and concerns about rising costs for schools. From 2017 to 2019, 183 international students, principally from East Asia and Southeast Asia, were infected with VPDs, particularly tuberculosis (99 cases) and varicella (71 cases). Whereas the majority of Japanese educational institutions screen international students for tuberculosis (TB) at admission, only a few institutions request proof of antibody testing relating to other VPDs or of vaccination. These findings will help formulate guidelines for checkups related to vaccination for international students required to protect the educational institutions in Japan from the spread of VPDs. In addition, providing multifaceted social support, including financial compensation for institutions and enhanced international students' health issues, would be helpful.
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- 2022
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9. A comparative study of the sarcopenia screening in older patients with interstitial lung disease.
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Hanada M, Sakamoto N, Ishimoto H, Kido T, Miyamura T, Oikawa M, Nagura H, Takeuchi R, Kawazoe Y, Sato S, Hassan SA, Ishimatsu Y, Takahata H, Mukae H, and Kozu R
- Subjects
- Activities of Daily Living, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Humans, Japan epidemiology, Male, Middle Aged, Muscle Strength, Sarcopenia epidemiology, Sensitivity and Specificity, Surveys and Questionnaires, Lung Diseases, Interstitial complications, Sarcopenia complications, Sarcopenia diagnosis
- Abstract
Background: The Asian Working Group for Sarcopenia 2019 (AWGS 2019) is the gold standard diagnostic criteria for sarcopenia in Asian populations. The calf circumference (CalF), the strength, assistance in walking, rising from a chair, climbing stairs, and falls (SARC-F) and the SARC-CalF questionnaires for sarcopenia screening have been used by AWGS 2019. The aim of this study was to assess accuracy of these three sarcopenia screening tools in patients with interstitial lung disease., Methods: In this cross-sectional study, stable patients with interstitial lung disease were enrolled. The SARC-F, SARC-CalF, and CalF, used in patients with interstitial lung disease, were compared to the diagnostic criteria proposed by AWGS 2019. The accuracy of screening tools was compared using sensitivity and specificity. Moreover, areas under the receiver operating characteristic curves (AUC) were computed., Results: Seventy eight patients were analyzed, and sarcopenia was identified in 25 (32.1%) patients with interstitial lung disease by the AWGS 2019 criteria. The sensitivity of the CalF was highest (96%) of the three screening tools, while the specificity was 60%. The sensitivity of SARC-F and SARC-CalF were 24% and 68%, while the specificity were 92% and 66%, respectively. The AUCs of CalF, SARC-F, and SARC-CalF in all patients were 0.78, 0.58, and 0.67, respectively., Conclusions: The CalF is most suitable for screening sarcopenia in patients with interstitial lung disease, while SARC-F and SARC-CalF are not., (© 2022. The Author(s).)
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- 2022
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10. Assessment of the association between dysphagia and sarcopenia among elderly patients with cirrhosis: Usefulness of the finger-ring test.
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Haraguchi M, Miyaaki H, Nakamura Y, Narita S, Matsumoto K, Fukushima M, Sasaki R, Miuma S, Takahata H, Yamaguchi N, and Nakao K
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- Aged, Hand Strength, Humans, Liver Cirrhosis, Middle Aged, Muscle, Skeletal, Deglutition Disorders, Sarcopenia
- Abstract
Aim: Sarcopenic dysphagia has become an urgent matter of debate in our aging society. However, little is known about the relationship between sarcopenia and dysphagia in patients with liver cirrhosis. Our aim was to assess sarcopenia and dysphagia among elderly patients with cirrhosis using two easy-to-use screening tests, i.e., the eating assessment tool-10 and the finger-ring test., Methods: The eating assessment tool-10, handgrip strength, skeletal muscle mass index, computed tomography, and the finger-ring test were included in our analysis. One hundred patients with cirrhosis and without a history of aspiration pneumonia were divided into the elderly (≥75 years) and non-elderly (<75 years) groups., Results: In the elderly group, sarcopenia was identified in 56.5% of the patients; of these, 30.4% and 13.0% had eating assessment tool-10 scores of ≥2 and ≥3, respectively. Sarcopenia-related factors correlated significantly with the eating assessment tool-10 scores (p<0.01). Multivariate regression analysis revealed that sarcopenia was significantly associated with dysphagia (p=0.028; odds ratio, 7.27). Among the elderly patients, the calf size of the non-dominant lower limb was less than the finger-ring circumference in 37.0% of the patients. This group had a significantly higher proportion of patients with an eating assessment tool-10 score of ≥2 than those with a greater calf than finger-ring circumference (p<0.01)., Conclusions: Sarcopenia, rather than the hepatic reserve function, is associated with dysphagia among elderly patients with cirrhosis. The finger-ring test might be useful in screening for dysphagia., (Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Published
- 2021
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11. Comparative study of the effect of neuromuscular electrical stimulation and oral administration of branched-chain amino acid on preventing sarcopenia in patients after living-donor liver transplantation: study protocol for an open-label randomized controlled trial.
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Haraguchi M, Ichinose K, Miyaaki H, Hanada M, Fukushima M, Sasaki R, Miuma S, Hara T, Kugiyama T, Soyama A, Hidaka M, Tsuji A, Yano R, Sekino M, Takahata H, Eguchi S, and Nakao K
- Subjects
- Administration, Oral, Amino Acids, Branched-Chain, Electric Stimulation, Humans, Japan, Living Donors, Muscle, Skeletal pathology, Randomized Controlled Trials as Topic, Electric Stimulation Therapy, Liver Transplantation adverse effects, Sarcopenia diagnosis, Sarcopenia etiology, Sarcopenia prevention & control
- Abstract
Background: Liver cirrhosis is the irreversible fibrosis of the liver and causes refractory ascites and hepatic encephalopathy, which might not respond to treatment. Living donor liver transplantation (LDLT) is an effective treatment for patients with cirrhosis. However, post-LDLT patients are prone to muscle atrophy and sarcopenia. Therefore, physiotherapy of post-LDLT patients is essential for preventing the progression of sarcopenia. Recently, rehabilitation using neuromuscular electrical stimulation (NMES) has been reported to be useful for preventing the progression of sarcopenia. Similarly, nutrition therapy is essential for post-LDLT patients because these patients frequently experience malnutrition. However, the effects of combined NMES and nutrition therapy on post-LDLT patients remain unknown., Methods/design: This open-label, randomized, parallel-group study will compare the effects of combined therapy with NMES and branched-chain amino acids (BCAA) with those of NMES alone in patients with decompensated cirrhosis after LDLT. After LDLT, 50 patients with decompensated cirrhosis will be randomly assigned to receive NMES with BCAA or NMES without BCAA. The duration of the intervention will be 3 months. To analyze the change in skeletal muscle mass, InBody 770 body composition and body water analysis and ultrasonography will be performed before LDLT and 4 weeks and 12 weeks post-LDLT. The primary endpoint is changes in the skeletal muscle mass from baseline to 3 months. Important secondary endpoints are the changes in the skeletal muscle mass from baseline to 1 month and changes in the quadriceps strength from baseline to 1 month., Discussion: The results of this study are expected to provide evidence regarding the effect of NMES combined with BCAA therapy on the skeletal muscle of post-LDLT patients., Trial Registration: Japan Registry of Clinical Research jRCTs071190051 . Registered on February 26, 2020.
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- 2021
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12. Efficacy of nasal high flow therapy on the coordination between breathing and swallowing of saliva during daytime nap in chronic obstructive pulmonary disease patients: A single center, randomized crossover controlled study.
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Ayuse T, Hisamatsu N, Yamaguchi T, Takahashi Y, Tamada Y, Kurata S, Mishima G, Pinkham M, Tatkov S, Takahata H, and Ayuse T
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- Humans, Cannula, Research Design, Saliva, Randomized Controlled Trials as Topic, Cross-Over Studies, Deglutition physiology, Noninvasive Ventilation adverse effects, Noninvasive Ventilation methods, Pulmonary Disease, Chronic Obstructive physiopathology, Pulmonary Disease, Chronic Obstructive therapy, Respiratory Mechanics physiology
- Abstract
Background: There are some clinical reports on dysphagia in patients with chronic obstructive pulmonary disease (COPD); however, its pathophysiology remains largely unknown.Changes in respiratory function occur in patients with COPD causing a decrease in tidal volume and an increase in respiratory rate (tachypnea). In addition, it leads to lack of coordination between respiration and swallowing.A new treatment called nasal high flow (NHF) has been introduced for patients with COPD, replacing the traditional non-invasive ventilation (NIV) procedure. The NHF therapy involves inhalation of high flow of humidified air, which reduces respiratory effort in patients with COPD. Furthermore, NHF therapy facilitates swallowing of saliva even during respiratory management. A recent clinical study reported that high-flow nasal cannula oxygen therapy for 6 weeks improved the health-related quality of life and reduced hypercapnia in patients with stable COPD. Taken together, NHF therapy is gaining attention in the clinical management of patients with COPD.Therefore, in this study, we aim to examine the efficacy of NHF therapy on the coordination between breathing and swallowing of saliva during daytime nap in patients with COPD., Methods/design: This open-label, investigator-initiated, single center study will evaluate the efficacy of NHF therapy on the coordination between breathing and swallowing of saliva during the daytime nap in COPD patients with forced expiratory volume in 1 second (FEV1%) of <70% during treatment at the Nagasaki University Hospital Respiratory Rehabilitation Center. Evaluations will be performed during the 90 to 180 minute "daytime nap" in the measurement room of the hospital. The primary endpoint will be the rate of appearance of the expiratory phase after swallowing of saliva and the frequency of swallowing during the measurement period., Discussion: The purpose of this study is to obtain evidence regarding the utility of NHF as a potential therapeutic device for COPD patients to prevent aspiration of saliva during the sleep stage of daytime nap. The utility will be assessed by comparing the decrease in incidence rates of the expiratory phase after swallowing of saliva in the NHF device group and the control group, wherein this device was not used.
- Published
- 2020
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13. [A Case of Subarachnoid Hemorrhage and Cerebellar Hemorrhage after Lumbar Spine Surgery Associated with Basilar Artery Aneurysm].
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Sakata N, Takahata H, Matsuo A, Hiu T, Ono T, Kawahara I, Ito T, Moritsuka T, Honda K, Haraguchi W, Ushijima R, and Tsutsumi K
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- Basilar Artery, Cerebral Hemorrhage, Humans, Neurosurgical Procedures, Aneurysm, Ruptured surgery, Intracranial Aneurysm complications, Intracranial Aneurysm diagnostic imaging, Intracranial Aneurysm surgery, Subarachnoid Hemorrhage diagnostic imaging, Subarachnoid Hemorrhage etiology, Subarachnoid Hemorrhage surgery
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- 2020
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14. Human immunodeficiency virus-associated vacuolar encephalomyelopathy with granulomatous-lymphocytic interstitial lung disease improved after antiretroviral therapy: a case report.
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Akagi K, Yamamoto K, Umemura A, Ide S, Hirayama T, Takazono T, Imamura Y, Miyazaki T, Sakamoto N, Shiraishi H, Takahata H, Zaizen Y, Fukuoka J, Morikawa M, Ashizawa K, Teruya K, Izumikawa K, and Mukae H
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- Adult, Diagnosis, Differential, HIV pathogenicity, HIV Infections diagnosis, Humans, Lung pathology, Lung Diseases, Interstitial virology, Male, Vacuoles pathology, Anti-Retroviral Agents therapeutic use, HIV drug effects, HIV Infections complications, HIV Infections drug therapy, Lung Diseases, Interstitial diagnosis, Lysosomal Storage Diseases virology, Muscular Diseases virology
- Abstract
Background: Vacuolar encephalomyelopathy, a disregarded diagnosis lately, was a major neurological disease in the terminal stages of human immunodeficiency virus (HIV)-1 infection in the pre-antiretroviral therapy (ART) era. Granulomatous-lymphocytic interstitial lung disease (GLILD) was classically identified as a non-infectious complication of common variable immunodeficiency; however, it is now being recognized in other immunodeficiency disorders. Here, we report the first case of GLILD accompanied by vacuolar encephalomyelopathy in a newly diagnosed HIV-infected man., Case Presentation: A 40-year-old Japanese man presented with chronic dry cough and progressing paraplegia. Radiological examination revealed diffuse pulmonary abnormalities in bilateral lungs, focal demyelinating lesions of the spinal cord, and white matter lesions in the brain. He was diagnosed with GLILD based on marked lymphocytosis detecting in bronchoalveolar lavage, and transbronchial-biopsy proven T-cellular interstitial lung disease with granulomas. Microbiological examinations did not reveal an etiologic agent. The patient was also diagnosed with HIV-associated vacuolar encephalomyelopathy on the basis of an elevated HIV viral load in cerebrospinal fluid. After initiating ART, the brain lesions and paraplegia improved significantly, and interstitial abnormalities of the lungs and cough disappeared., Conclusion: This report highlights that even in the post-ART era in developed countries with advanced healthcare services, HIV-associated vacuolar encephalomyelopathy should be considered in the differential diagnosis of a progressive neurological disorder during the first visit. Furthermore, GLILD may represent an HIV-associated pulmonary manifestation that can be treated by ART.
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- 2020
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15. The pilot study examining the effects of swallowing position on lung volume fraction and the coordination between respiration and non-nutritive swallowing reflex.
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Yamaguchi-Komeyama K, Ayuse T, Mikushi S, Hisamatsu N, Yamaguchi T, Magata N, Tanoue N, Kawasaki H, Kozu R, Takahata H, and Ayuse T
- Subjects
- Adult, Female, Healthy Volunteers, Humans, Lung Volume Measurements, Male, Pilot Projects, Young Adult, Abdominal Muscles physiology, Apnea physiopathology, Deglutition, Posture, Reflex physiology, Respiration
- Abstract
Background: Body position might affect the coordination between respiration and swallowing. This study was carried out to test the hypothesis that during swallowing, coordinated movements of muscle groups such as the diaphragm and rectus abdominis muscles are important to control normal swallowing apnea., Objective: To investigate this hypothesis, respiratory parameters, swallowing apnea and muscle activity were measured in each of four body positions: sitting position with feet on the floor, 30° reclining position, lateral position, and standing position., Methods: All measurements were performed in nine healthy subjects. Nasal airflow was measured using a pneumotachometer and muscle activity was measured using an electromyograph. All lung volume fraction parameters were measured using spirometer and swallowing apnea time was calculated., Results: The maximum inspiratory volume was 2.76 ± 0.83 L in the 30° reclining position, which was significantly larger than that in the other positions (p = .0001). The preliminary expiratory volume was 1.05 ± 0.42 L in the 30° reclining position, which was significantly smaller than that in the other positions (p < .0001). The swallowing apnea time during water swallowing was 1.17 ± 0.35 sec in the lateral position and 0.87 ± 0.28 sec in the 30° reclining position, which tended to be longer than the 0.78 sec in the sitting position., Conclusion: We conclude that both lateral and reclining positions require a longer period of swallowing apnea compared to the sitting and standing positions. Differences in body position may significantly influence the coordination between respiration and swallowing., (© 2020 The Authors. Clinical and Experimental Dental Research published by John Wiley & Sons Ltd.)
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- 2020
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16. FLCN alteration drives metabolic reprogramming towards nucleotide synthesis and cyst formation in salivary gland.
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Isono Y, Furuya M, Kuwahara T, Sano D, Suzuki K, Jikuya R, Mitome T, Otake S, Kawahara T, Ito Y, Muraoka K, Nakaigawa N, Kimura Y, Baba M, Nagahama K, Takahata H, Saito I, Schmidt LS, Linehan WM, Kodama T, Yao M, Oridate N, and Hasumi H
- Subjects
- Adult, Animals, Basic Helix-Loop-Helix Leucine Zipper Transcription Factors metabolism, Cysts diagnostic imaging, Female, Gene Ontology, Glycolysis, Humans, Male, Mice, Knockout, Middle Aged, Organelle Biogenesis, Pentose Phosphate Pathway, Proto-Oncogene Proteins deficiency, Salivary Glands diagnostic imaging, TOR Serine-Threonine Kinases metabolism, Tumor Suppressor Proteins deficiency, Up-Regulation, Cysts metabolism, Cysts pathology, Nucleotides biosynthesis, Proto-Oncogene Proteins metabolism, Salivary Glands metabolism, Salivary Glands pathology, Tumor Suppressor Proteins metabolism
- Abstract
FLCN is a tumor suppressor gene which controls energy homeostasis through regulation of a variety of metabolic pathways including mitochondrial oxidative metabolism and autophagy. Birt-Hogg-Dubé (BHD) syndrome which is driven by germline alteration of the FLCN gene, predisposes patients to develop kidney cancer, cutaneous fibrofolliculomas, pulmonary cysts and less frequently, salivary gland tumors. Here, we report metabolic roles for FLCN in the salivary gland as well as their clinical relevance. Screening of salivary glands of BHD patients using ultrasonography demonstrated increased cyst formation in the salivary gland. Salivary gland tumors that developed in BHD patients exhibited an upregulated mTOR-S6R pathway as well as increased GPNMB expression, which are characteristics of FLCN-deficient cells. Salivary gland-targeted Flcn knockout mice developed cytoplasmic clear cell formation in ductal cells with increased mitochondrial biogenesis, upregulated mTOR-S6K pathway, upregulated TFE3-GPNMB axis and upregulated lipid metabolism. Proteomic and metabolite analysis using LC/MS and GC/MS revealed that Flcn inactivation in salivary gland triggers metabolic reprogramming towards the pentose phosphate pathway which consequently upregulates nucleotide synthesis and redox regulation, further supporting that Flcn controls metabolic homeostasis in salivary gland. These data uncover important roles for FLCN in salivary gland; metabolic reprogramming under FLCN deficiency might increase nucleotide production which may feed FLCN-deficient salivary gland cells to trigger tumor initiation and progression, providing mechanistic insight into salivary gland tumorigenesis as well as a foundation for development of novel therapeutics for salivary gland tumors., Competing Interests: Declaration of competing interest Authors declare no conflict of interest., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2020
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17. Rare squamous cell carcinoma arising from a presacral epidermoid cyst: A case report.
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Ohsawa M, Kagawa T, Ochiai R, Kobayashi N, Hato S, Nozaki I, Takahata H, Teramoto N, and Kobatake T
- Abstract
Introduction: Presacral epidermoid cysts are uncommon, usually benign cysts caused by developmental abnormalities in the fetal period. We present a rare case of squamous cell carcinoma arising from a presacral epidermoid cyst., Presentation of Case: A 59-year-old woman complained of tenesmus and discomfort in the buttocks. Computed tomography revealed a 50-mm well-defined cystic mass in the presacrum and a 70-mm solid mass extending from the cyst into the rectum, vagina, and left sciatic spine. On T1-weighted magnetic resonance images, the cyst was unilocular and the mass was marginated with low intensity. On T2-weighted images, the mass had high intensity. A malignant presacral developmental cyst was diagnosed, without obvious metastasis. Using abdominal and parasacral approaches, Hartmann's operation was performed with multiorgan resection, including the sacrum, coccyx, left sciatic spine, internal obturator muscle, rectum, and uterine appendage. Histopathology of the excised specimen revealed a squamous cell carcinoma originating from the presacral epidermoid cyst., Discussion: Reports of malignant transformation of epidermoid cysts in the presacral space, as in the present case, are extremely rare. Because of their unusual location and slow growth, epidermoid cysts tend to remain asymptomatic. Because the patient had a malignant tumor with suspected invasion of adjacent organs, combination surgery was selected., Conclusion: Although further research is required, presacral epidermoid cysts are extremely rare and may be malignant. Thorough preoperative image evaluation is crucial for complete resection., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2019 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
- Published
- 2020
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18. Geriatric Nutritional Risk Index, a predictive assessment tool, for postoperative complications after abdominal surgery: A prospective multicenter cohort study.
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Hanada M, Yamauchi K, Miyazaki S, Hirasawa J, Oyama Y, Yanagita Y, Takahata H, and Kozu R
- Subjects
- Abdomen surgery, Aged, Cohort Studies, Comorbidity, Female, Humans, Japan epidemiology, Male, Nutritional Status, Predictive Value of Tests, Prospective Studies, Activities of Daily Living, Geriatric Assessment methods, Malnutrition diagnosis, Malnutrition epidemiology, Nutrition Assessment, Postoperative Complications diagnosis, Postoperative Complications etiology, Postoperative Complications prevention & control, Risk Assessment methods, Surgical Procedures, Operative adverse effects, Surgical Procedures, Operative rehabilitation
- Abstract
Aim: Patients awaiting abdominal surgery are often malnourished, which puts them at a high risk of postoperative complications. The aim of the present study was to investigate the effects of preoperative nutritional status using the Geriatric Nutritional Risk Index (GNRI) on postoperative complications and the course of recovery for patients undergoing abdominal surgery., Methods: In this prospective multicenter cohort study, we enrolled patients awaiting abdominal surgery from November 2015 to December 2017. The characteristics of patients and postoperative complications were compared between participants (median age 71 years; interquartile range 66-78 years) with low GNRI (<98) values and high GNRI (≥98) values. Multivariate logistic regression was carried out to identify postoperative complications-related factors., Results: A total of 366 patients who underwent abdominal surgery were assessed. Patients in the low GNRI group had a significantly higher rate of postoperative complications (P = 0.01), and longer length of hospital stay compared with those in the high GNRI group (P < 0.01). Using multivariate analysis, low GNRI was found to be independently associated with postoperative complications (OR 2.50; P = 0.02) and activities of daily living on postoperative day 7 (OR 1.39; P = 0.03). Comorbidities, handgrip force for postoperative complications, age, preoperative chemotherapy and activities of daily living on postoperative day 7 were not independently associated., Conclusions: Malnutrition indicated by the GNRI might be predictive of postoperative complications after abdominal surgery and the delay of postoperative course. Geriatr Gerontol Int 2019; 19: 924-929., (© 2019 Japan Geriatrics Society.)
- Published
- 2019
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19. Peripheral gabapentin regulates mosquito allergy-induced itch in mice.
- Author
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Akiyama T, Andoh T, Ohtsuka E, Nojima H, Ouchi H, Takahata H, and Kuraishi Y
- Subjects
- Animals, Gabapentin, Hypersensitivity metabolism, Male, Mice, Inbred ICR, Neurons metabolism, Peripheral Nerves drug effects, Peripheral Nerves physiology, Pruritus metabolism, Receptors, Histamine H1 metabolism, TRPV Cation Channels metabolism, Amines pharmacology, Amines therapeutic use, Antipruritics pharmacology, Antipruritics therapeutic use, Calcium Channels metabolism, Culicidae immunology, Cyclohexanecarboxylic Acids pharmacology, Cyclohexanecarboxylic Acids therapeutic use, Hypersensitivity drug therapy, Pruritus drug therapy, Saliva immunology, gamma-Aminobutyric Acid pharmacology, gamma-Aminobutyric Acid therapeutic use
- Abstract
The antipruritic activity of gabapentin, an anticonvulsant, was studied in a mouse model of allergic itch. In mice sensitized by an extract of the salivary glands of the mosquito (ESGM), an intradermal injection of ESGM elicited scratching and increased peripheral nerve firing. Oral or intradermal administration of gabapentin at the ESGM injection site inhibited ESGM-induced scratching and peripheral nerve firing. However, gabapentin did not affect histamine-induced scratching. The distributions of immunoreactivity to the voltage-dependent calcium channel α
2 δ-1 subunit, a site of gabapentin action, and the histamine H1 receptor differed in the mouse dorsal root ganglia. The α2 δ-1 subunit was mainly found in neurons that were 15-20 µm in diameter, whereas the H1 receptor was mainly in 20-30 µm neurons. In addition, α2 δ-1 subunit immunoreactivity co-localized with that of transient receptor potential vanilloid 1 (TRPV1). These results suggest that gabapentin regulates allergic itch by acting on the calcium channel α2 δ-1 subunit in peripheral TRPV1-positive neurons., (Copyright © 2018 Elsevier B.V. All rights reserved.)- Published
- 2018
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20. Parotid Oncocytoma as a Manifestation of Birt-Hogg-Dubé Syndrome.
- Author
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Yoshida K, Miyagawa M, Kido T, Ide K, Sano Y, Sugawara Y, Takahata H, Monden N, Furuya M, and Mochizuki T
- Abstract
Birt-Hogg-Dubé syndrome (BHD) is a rare autosomal dominant disease characterized by skin fibrofolliculomas, pulmonary cysts, spontaneous pneumothoraces, and renal cancers. Oncocytomas are benign epithelial tumors that are also rare. Recently, there have been a few case reports of BHD with a parotid oncocytoma that appears to have a BHD phenotype. Here we document the eighth known case and describe the magnetic resonance imaging features of the parotid oncocytoma, which mimicked Warthin's tumor. Radiologists should be aware of the association between these rare disorders.
- Published
- 2018
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21. CD10 down expression in follicular lymphoma correlates with gastrointestinal lesion involving the stomach and large intestine.
- Author
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Ohnishi N, Takata K, Miyata-Takata T, Sato Y, Tari A, Gion Y, Noujima-Harada M, Taniguchi K, Tabata T, Nagakita K, Omote S, Takahata H, Iwamuro M, Okada H, Maeda Y, Yanai H, and Yoshino T
- Subjects
- Adult, Aged, Aged, 80 and over, Algorithms, Female, Humans, Immunohistochemistry, In Situ Hybridization, Fluorescence, Intestine, Large enzymology, Lymphoma, Follicular diagnosis, Lymphoma, Follicular genetics, Male, Middle Aged, Neprilysin biosynthesis, Neprilysin genetics, Polymerase Chain Reaction, Stomach enzymology, Down-Regulation, Gene Expression Regulation, Neoplastic, Intestine, Large pathology, Lymphoma, Follicular enzymology, Lymphoma, Follicular pathology, Neprilysin metabolism, Stomach pathology
- Abstract
Follicular lymphoma (FL) shows co-expression of B-cell lymphoma 2 (BCL2) and CD10, whereas downexpression of CD10 is occasionally experienced in gastrointestinal (GI) FL with unknown significance. Gastrointestinal FL is a rare variant of FL, and its similarity with mucosa-associated lymphoid tissue lymphoma was reported. We investigated the clinicopathological and genetic features of CD10 downexpressed (CD10
down ) GI-FL. The diagnosis of CD10down FL was carried out with a combination of pathological and molecular analyses. The incidence of CD10down GI-FL was shown in 35/172 (20.3%) cases, which was more frequent than nodal FL (3.5%, P < 0.001). The difference was additionally significant between GI-FL and nodal FL when the analysis was confined to primary GI-FL (55.2% vs 3.5%, P < 0.001). Compared to CD10+ GI-FL, CD10down GI-FL significantly involved the stomach or large intestine (P = 0.015), and additionally showed the downexpression of BCL6 (P < 0.001). The follicular dendritic cell meshwork often showed a duodenal pattern in the CD10down group (P = 0.12). Furthermore, a lymphoepithelial lesion was observed in 5/12 (40%) gastric FL cases, which indicated caution in the differentiation of mucosa-associated lymphoid tissue lymphoma. Molecular analyses were undertaken in seven cases of CD10down GI-FL, and an identical clone was found between CD10down follicles and CD10+ BCL2+ neoplastic follicles. In the diagnosis of cases with CD10down BCL2+ follicles, careful examination with molecular studies should be carried out., (© 2016 The Authors. Cancer Science published by John Wiley & Sons Australia, Ltd on behalf of Japanese Cancer Association.)- Published
- 2016
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22. A novel predictive factor for the onset time of docetaxel-induced onychopathy: a multicenter retrospective study.
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Takahata H, Tanabe K, Takaki A, Yamanouchi T, Mimura Y, Nitta A, Yasuda H, Kashii T, and Adachi I
- Abstract
Background: Taxanes are known to cause onychopathy. Previous studies have reported the relationship between onychopathy and paclitaxel dosing intervals and cumulative doses. However, there are no studies of the predictive factors for docetaxel-induced nail changes. The present study used the drug accumulation rate (mg/m
2 /day) as a novel indicator and evaluated its usefulness for the prediction of onychopathy., Methods: From January 2008 to December 2009, we examined patients who received docetaxel at the Toyama University Hospital and Tonami General Hospital to determine the time to onset of onychopathy, the accumulation rate, and the cumulative dose. We then divided the study subjects into two groups, and used Receiver Operating Characteristic (ROC) analysis to calculate a cut-off value. We evaluated both indicators as predictive factors for onychopathy using the log-rank test and Cox proportional hazards model., Results: Ninety-five patients were included in the present study. The results of the log-rank test sub-analysis revealed that the median number of days until onychopathy onset was significantly shorter in patients with an accumulation rate greater than the cut-off ( P = 0.009), and in those with a cumulative dose below the cut-off ( P < 0.001). The hazard ratios for the accumulation rate and cumulative dose, evaluated using Cox proportional hazards regression analysis, were 1.44 ( P = 0.036) and 0.99 ( P < 0.001), respectively., Conclusions: The results of the present study indicated that the drug accumulation rate influenced the time to onset of docetaxel-induced onychopathy., Trial Registration: This study is not applicable for trial registration due to retrospective chart review without intervention.- Published
- 2016
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23. Docking study and biological evaluation of pyrrolidine-based iminosugars as pharmacological chaperones for Gaucher disease.
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Kato A, Nakagome I, Sato K, Yamamoto A, Adachi I, Nash RJ, Fleet GW, Natori Y, Watanabe Y, Imahori T, Yoshimura Y, Takahata H, and Hirono S
- Subjects
- Dose-Response Relationship, Drug, Fibroblasts drug effects, Fibroblasts metabolism, Gaucher Disease metabolism, Glucosylceramidase antagonists & inhibitors, Glucosylceramidase metabolism, Glycoside Hydrolase Inhibitors chemical synthesis, Glycoside Hydrolase Inhibitors chemistry, Glycoside Hydrolase Inhibitors pharmacology, Humans, Imino Sugars chemical synthesis, Structure-Activity Relationship, Gaucher Disease drug therapy, Imino Sugars chemistry, Imino Sugars pharmacology, Molecular Docking Simulation, Pyrrolidines chemistry, Pyrrolidines pharmacology
- Abstract
We report on the synthesis and biological evaluation of a series of α-1-C-alkylated 1,4-dideoxy-1,4-imino-d-arabinitol (DAB) derivatives as pharmacological chaperones for Gaucher disease. The parent compound, DAB, did not show inhibition of human β-glucocerebrosidase but showed moderate intestinal α-glucosidase inhibition; in contrast, extension of α-1-C-alkyl chain length gave a series of highly potent and selective inhibitors of the β-glucocerebrosidase. Our design of α-1-C-tridecyl-DAB (5j) produced a potent inhibitor of the β-glucocerebrosidase, with IC50 value of 0.77 μM. A molecular docking study revealed that the α-1-C-tridecyl group has a favorable interaction with the hydrophobic pocket and the sugar analogue part (DAB) interacted with essential hydrogen bonds formed to Asp127, Glu235 and Glu340. Furthermore, α-1-C-tridecyl-DAB (5j) displayed enhancement of activity at an effective concentration 10-times lower than isofagomine. α-1-C-Tridecyl-DAB therefore provides the first example of a pyrrolidine iminosugar as a new class of promising pharmacological chaperones with the potential for treatment of Gaucher disease.
- Published
- 2016
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24. A rare case of inflammatory myofibroblastic tumor of the diaphragmatic parietal pleura with dissemination.
- Author
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Ueno T, Yamashita M, Sawada S, Suehisa H, Kawamoto H, and Takahata H
- Subjects
- Adult, Female, Humans, Immunohistochemistry, Tomography, X-Ray Computed, Diaphragm pathology, Granuloma, Plasma Cell pathology, Pleura pathology
- Abstract
Inflammatory myofibroblastic tumor (IMT) is a rare neoplasm that occurs at different sites in the body. Pleural IMT in particular is especially rare. IMTs infrequently tend to have malignancy. We report a rare case of advanced diaphragmatic parietal pleural IMT with dissemination. A 30-year-old woman complained of right upper abdominal pain. Computed tomography showed a large lobulated mass over the right diaphragm, but no disseminated nodules were noted. Intraoperatively, we found the primary tumor arising from the diaphragmatic parietal pleura and a dozen disseminated nodules, and we removed them completely. The histopathological and immunohistochemical diagnosis was IMT.
- Published
- 2015
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25. A mouse model of peripheral postischemic dysesthesia: involvement of reperfusion-induced oxidative stress and TRPA1 channel.
- Author
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Sasaki A, Mizoguchi S, Kagaya K, Shiro M, Sakai A, Andoh T, Kino Y, Taniguchi H, Saito Y, Takahata H, and Kuraishi Y
- Subjects
- Animals, Ischemia complications, Male, Mice, Mice, Inbred C57BL, Paresthesia etiology, Reperfusion Injury complications, TRPA1 Cation Channel, Disease Models, Animal, Hindlimb blood supply, Oxidative Stress physiology, Paresthesia metabolism, Reperfusion Injury metabolism, Transient Receptor Potential Channels metabolism
- Abstract
Peripheral postischemic dysesthesia was examined behaviorally in mice and we investigated the underlying molecular mechanism with a focus on oxidative stress. Hind-paw ischemia was induced by tight compression of the ankle with a rubber band, and reperfusion was achieved by cutting the rubber tourniquet. We found that reperfusion after ischemia markedly provoked licking of the reperfused hind paw, which was significantly inhibited by systemic administration of the antioxidant N-acetyl-l-cysteine and the transient receptor potential (TRP) A1 channel blocker HC-030031 [2-(1,3-dimethyl-2,6-dioxo-1,2,3,6-tetrahydro-7H-purin-7-yl)-N-(4-isopropylphenyl)acetamide]. Postischemic licking was also significantly inhibited by an intraplantar injection of another antioxidant, phenyl-N-tert-butylnitrone. The TRPV1 channel blocker BCTC [N-(4-tert-butylphenyl)-4-(3-chloropyridin-2-yl)tetrahydropyrazine-1(2H)-carboxamide] did not inhibit postischemic licking. An intraplantar injection of hydrogen peroxide elicited hind-paw licking, which was inhibited by N-acetyl-l-cysteine, phenyl-N-tert-butylnitrone, and HC-030031. Postischemic licking was not affected by chemical depletion of sensory C-fibers, but it was inhibited by morphine, which has been shown to inhibit the C- and Aδ-fiber-evoked responses of dorsal horn neurons. Interestingly, postischemic licking was not inhibited by gabapentin and pregabalin, which have been shown to inhibit the C-fiber- but not Aδ-fiber-evoked response. The present results suggest that ischemia-reperfusion induces oxidative stress, which activates TRPA1 channels to provoke postischemic licking. It has been suggested that this behavior is mediated by myelinated (probably Aδ-type) afferent fibers. Oxidative stress and TRPA1 channels may be potential targets to treat peripheral ischemia-associated dysesthesia., (Copyright © 2014 by The American Society for Pharmacology and Experimental Therapeutics.)
- Published
- 2014
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26. A case of pemphigus herpetiformis-like atypical pemphigus with IgG anti-desmocollin 3 antibodies.
- Author
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Nakamura Y, Takahata H, Teye K, Ishii N, Hashimoto T, and Muto M
- Subjects
- Dermatitis Herpetiformis diagnosis, Humans, Male, Middle Aged, Pemphigus diagnosis, Antibodies, Anti-Idiotypic metabolism, Dermatitis Herpetiformis immunology, Desmocollins immunology, Pemphigus immunology
- Published
- 2014
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27. Development of a novel marking system for laparoscopic gastrectomy using endoclips with radio frequency identification tags: feasibility study in a canine model.
- Author
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Kojima F, Sato T, Tsunoda S, Takahata H, Hamaji M, Komatsu T, Okada M, Sugiura T, Oshiro O, Sakai Y, Date H, and Nakamura T
- Subjects
- Animals, Dogs, Feasibility Studies, Gastrectomy instrumentation, Laparoscopy instrumentation, Surgical Instruments, Gastrectomy methods, Laparoscopy methods, Radio Frequency Identification Device methods
- Abstract
Background: Intraoperative identification of early gastric cancer is difficult to conduct during laparoscopic procedures. In this study, we investigated the feasibility and accuracy of a newly developed marking system using endoclips with radio frequency identification (RFID) tags in a canine model., Methods: RFID is a wireless near field communication technology. Among the open frequency bands available for medical use, 13.56 MHz is suitable for a surgical marking system because of the similar and linear signal decay both in air and in biological tissues. The proposed system consists of four parts: (a) endoclips with RFID tags, (b) endo-clip applier equipment, (c) laparoscopic locating probe, and (d) signal processing units with audio interface. In the experimental setting using canine models, RFID-tagged endoclips were applied to the mucosa of each dog's stomach. During the subsequent operation, the clips with RFID tags placed in five dogs were located by the detection of the RFID signal from the tag (RFID group), and the conventional clips in the other six dogs were located by finger palpation (FP group). The detected sites were marked by ablation on the serosal surface. Distance between the clips and the metal pin needles indicating ablated sites were measured with X-ray radiographs of the resected specimen., Results: All clips were successfully detected by the marking system in the RFID group (10/10) and by finger palpation in the FP group (17/17). The medians of detection times were 31.5 and 25.0 s, respectively; the distances were 5.63 and 7.62 mm, respectively. The differences were not statistically significant. No adverse event related to the procedures was observed., Conclusions: Endoclips with RFID tags were located by our novel marking system in an experimental laparoscopic setting using canine stomachs with substantial accuracy comparable to conventional endoclips located by finger palpation through an open approach.
- Published
- 2014
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28. Synthesis and biological evaluation of α-1-C-4'-arylbutyl-L-arabinoiminofuranoses, a new class of α-glucosidase inhibitors.
- Author
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Natori Y, Sakuma T, Yoshimura Y, Kinami K, Hirokami Y, Sato K, Adachi I, Kato A, and Takahata H
- Subjects
- Dose-Response Relationship, Drug, Glycoside Hydrolase Inhibitors chemical synthesis, Glycoside Hydrolase Inhibitors chemistry, Humans, Imino Sugars chemical synthesis, Imino Sugars chemistry, Intestines enzymology, Molecular Structure, Structure-Activity Relationship, Glycoside Hydrolase Inhibitors pharmacology, Imino Sugars pharmacology, alpha-Glucosidases metabolism
- Abstract
A series of α-1-C-4'-arylbutyl-L-arabinoiminofuranoses 3 with functional groups attached to the phenyl ring, which are potential α-glycosidase inhibitors, was designed and synthesized by using a Negishi cross-coupling reaction as the key reaction. Arylbutyl derivatives 3a-e showed potent inhibitory activities against intestinal maltase. Among them, difluorophenylbutyl derivative 3e showed good inhibition activities against intestinal isomaltase and sucrase as compared to those of 1 and commercial drugs., (Copyright © 2014 Elsevier Ltd. All rights reserved.)
- Published
- 2014
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29. [Pulmonary non-tuberculous mycobacteriosis complicated with lung cancer].
- Author
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Suehisa H, Matsuda F, Kawamoto H, Ueno T, Sawada S, Yamashita M, Yamamoto S, Harada D, Kitajima H, Kozuki T, Nogami N, and Takahata H
- Subjects
- Anti-Bacterial Agents therapeutic use, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Biopsy, Combined Modality Therapy, Humans, Lung Neoplasms complications, Lung Neoplasms diagnostic imaging, Lung Neoplasms drug therapy, Male, Middle Aged, Mycobacterium avium-intracellulare Infection complications, Mycobacterium avium-intracellulare Infection diagnostic imaging, Mycobacterium avium-intracellulare Infection drug therapy, Pneumonectomy, Radiography, Treatment Outcome, Lung Neoplasms surgery, Mycobacterium avium-intracellulare Infection surgery
- Abstract
A 54-year-old man with pulmonary non-tuberculous mycobacteriosis( pulmonary NTM) who had been treated by antituberculous chemotherapy, developed a new nodule of 1.3 cm in size in the segment 1/2 of the right upper lobe. The cavity of 3.5 cm in size in the segment 6 of the right lower lobe from which Mycobacterium intracellulare was bronchoscopically detected, was suspected to be pulmonary NTM lesion. Since lung cancer was highly suspected by radiological examinations, right upper lobectomy and S6 segmentectomy were performed. Pathological diagnosis for the right upper lobe nodule was adenocarcinoma.
- Published
- 2014
30. [Timing of helicopter transportation for patients presenting with subarachnoid hemorrhage on isolated islands].
- Author
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Kawahara I, Matsunaga Y, Tsutsumi K, Takahata H, Ono T, Toda K, and Baba H
- Subjects
- Aged, Aged, 80 and over, Aneurysm, Ruptured etiology, Female, Humans, Islands, Male, Middle Aged, Recurrence, Subarachnoid Hemorrhage complications, Time Factors, Air Ambulances, Subarachnoid Hemorrhage therapy
- Abstract
Cerebral aneurysm re-rupture following subarachnoid hemorrhage(SAH)is a serious problem that is related with poor outcome. It is generally said that re-rupture occurs within 6 hours of the initial SAH;in the acute stage, strict management is needed even in the period before hospitalization. The aim of this study was to confirm whether patients on isolated islands should be transferred by helicopter > 6 hours after the initial SAH. Here we reviewed 125 cases of SAH in the isolated islands of Nagasaki prefecture between January 2007 and December 2012 who were transferred to Nagasaki Medical Center by helicopter as a result of consultation via TeleStroke(41 men, 84 women;mean age, 65.76 years). Re-rupture was observed in seven patients(5.6%), five of whom were diagnosed with re-rupture in a prior hospital on the isolated island. No patients demonstrated clinical deterioration during transport. Early helicopter transportation under adequate sedation and control of blood pressure within 6 hours is safe, and patients should be transferred as quickly as possible during the day. On the other hand, at night, flight safety must first be considered. Patients in stable clinical condition may be transferred the next day. We should pay special attention to patients with SAH and intracerebral hemorrhage, severe SAH, or vertebral artery dissecting aneurysm because their condition may gradually become more serious even if initially stable.
- Published
- 2014
31. A novel surgical marking system for small peripheral lung nodules based on radio frequency identification technology: Feasibility study in a canine model.
- Author
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Kojima F, Sato T, Takahata H, Okada M, Sugiura T, Oshiro O, Date H, and Nakamura T
- Subjects
- Animals, Disease Models, Animal, Dogs, Feasibility Studies, Pneumonectomy methods, Lung Diseases diagnosis, Lung Diseases surgery, Multiple Pulmonary Nodules diagnosis, Multiple Pulmonary Nodules surgery, Radio Frequency Identification Device
- Abstract
Objective: We investigated the feasibility and accuracy of a novel surgical marking system based on radiofrequency identification (RFID) technology for the localization of small peripheral lung nodules (SPLNs) in a canine model., Methods: The system consists of 4 components: (1) micro RFID tags (13.56 MHz, 1.0 × 1.0 × 0.8 mm), (2) a tag delivery system with a bronchoscope, (3) a wand-shaped locating probe (10-mm diameter), and (4) a signal processing unit with audio interface. Before the operation, pseudolesions mimicking SPLNs were prepared in 7 dogs by injecting colored collagen. By use of a computed tomographic (CT) guide, an RFID tag was placed via a bronchoscope close to each target lesion. This was then followed by scanning with the locating probe, and wedge resection was performed when possible. Operators can locate the tag by following the sound emitted by the system, which exhibits tone changes according to the tag-probe distance. The primary outcome measure was the rate of wedge resection with good margins., Results: A total of 10 pseudolesions imitating SPLNs were selected as targets. During thoracoscopic procedures, 9 of 10 tags were detected by the system within a median of 27 seconds. Wedge resections were performed for these 9 lesions with a median margin of 11 mm. The single failure was caused by tag dislocation to the central airway., Conclusions: Successful localization and wedge resection of pseudolesions with appropriate margins were accomplished in an experimental setting. Our RFID marking system has future applications for accurately locating SPLNs in a clinical setting., (Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.)
- Published
- 2014
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32. Asymmetric synthesis of 2,5-disubstituted 3-hydroxypyrrolidines based on stereodivergent intramolecular iridium-catalyzed allylic aminations.
- Author
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Natori Y, Kikuchi S, Kondo T, Saito Y, Yoshimura Y, and Takahata H
- Subjects
- Amination, Catalysis, Molecular Conformation, Pyrrolidines chemistry, Stereoisomerism, Allyl Compounds chemistry, Iridium chemistry, Pyrrolidines chemical synthesis
- Abstract
Intramolecular iridium-catalyzed allylic aminations of homochiral (E)-6-N-nosylaminohept-2-en-1-yl methyl carbonates were investigated. The relative position of the 2,5-substituents of the resulting pyrrolidines was found to be controlled by using both enantiomers (4 and 5) of the appropriate chiral ligand, demonstrating a simple and highly stereodivergent synthetic protocol. Selected trans- and cis-2,5-disubstituted 3-hydroxypyrrolidines (2a and 18a) were converted to (+)-bulgecinine (6) and (+)-preussin (7), respectively.
- Published
- 2014
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33. Gabapentin inhibits bortezomib-induced mechanical allodynia through supraspinal action in mice.
- Author
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Kitamura R, Andoh T, Mizoguchi S, Saito Y, Takahata H, and Kuraishi Y
- Subjects
- Adrenergic Neurons physiology, Amines administration & dosage, Animals, Antineoplastic Agents administration & dosage, Boronic Acids administration & dosage, Bortezomib, Cyclohexanecarboxylic Acids administration & dosage, Gabapentin, Mice, Mice, Inbred C57BL, Norepinephrine physiology, Pyrazines administration & dosage, Spinal Cord drug effects, gamma-Aminobutyric Acid administration & dosage, Amines pharmacology, Antineoplastic Agents adverse effects, Antineoplastic Agents antagonists & inhibitors, Boronic Acids adverse effects, Boronic Acids antagonists & inhibitors, Cyclohexanecarboxylic Acids pharmacology, Hyperalgesia chemically induced, Hyperalgesia drug therapy, Pyrazines adverse effects, Pyrazines antagonists & inhibitors, gamma-Aminobutyric Acid pharmacology
- Abstract
Bortezomib, an inhibitor of proteasome holoenzyme, is used to treat relapsed and refractory multiple myeloma. Peripheral neuropathy is a treatment-limiting adverse effect of bortezomib and is very difficult to control. In this study, we examined the efficacy of gabapentin in inhibiting bortezomib-induced peripheral neuropathy. Single intravenous injections of bortezomib (0.03 - 0.3 mg/kg) dose-dependently induced mechanical allodynia with a peak effect 12 days after injection. Bortezomib (0.3 mg/kg) also caused mechanical hyperalgesia, but neither affected thermal nociception nor induced cold allodynia. Bortezomib increased the response of the saphenous nerve to weak punctate stimulation but not response to cool stimulation of the skin. When administered 12 days after bortezomib injection, oral and intracisternal gabapentin markedly inhibited mechanical allodynia. Intrathecal, but not intraplantar, gabapentin had a tendency to reduce mechanical allodynia. The antiallodynic activity of orally administered gabapentin was suppressed by noradrenaline, but not serotonin, depletion in the spinal cord. Bortezomib did not affect the expression levels of the calcium channel α₂δ-1 subunit, a high-affinity binding site of gabapentin, in the plantar skin, spinal cord, medulla oblongata, and pons. These results suggest that gabapentin inhibits bortezomib-induced mechanical allodynia, most likely through the activation of the descending noradrenergic system.
- Published
- 2014
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34. Radiological findings of orbital infarction syndrome following intracranial aneurysm surgery.
- Author
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Morofuji Y, Tsutsumi K, Takahata H, Kawahara I, Hirao T, Toda K, and Baba H
- Subjects
- Cerebral Infarction etiology, Cerebral Infarction surgery, Humans, Light, Magnetic Resonance Imaging, Male, Middle Aged, Oculomotor Muscles pathology, Ophthalmoplegia etiology, Orbital Diseases etiology, Orbital Diseases surgery, Postoperative Complications surgery, Subarachnoid Hemorrhage complications, Subarachnoid Hemorrhage surgery, Tomography, X-Ray Computed, Vision Disorders etiology, Visual Acuity, Visual Perception, Cerebral Infarction diagnostic imaging, Intracranial Aneurysm complications, Intracranial Aneurysm surgery, Orbital Diseases diagnostic imaging, Postoperative Complications diagnostic imaging
- Published
- 2013
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35. Early awareness of cerebrospinal fluid hypovolemia after craniotomy for microsurgical aneurysmal clipping.
- Author
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Kawahara I, Tsutsumi K, Matsunaga Y, Takahata H, Ono T, Toda K, and Baba H
- Subjects
- Aged, Brain Edema complications, Brain Edema surgery, Drainage methods, Female, Humans, Hypovolemia diagnosis, Male, Microsurgery methods, Middle Aged, Postoperative Complications surgery, Tomography, X-Ray Computed methods, Cerebrospinal Fluid Pressure physiology, Craniotomy adverse effects, Early Diagnosis, Hypovolemia surgery, Subarachnoid Hemorrhage surgery
- Abstract
Background: Mild cerebrospinal fluid (CSF) hypovolemia is a well-known clinical entity, but critical CSF hypovolemia that can cause transtentorial herniation is an unusual and rare clinical entity that occurs after craniotomy. We investigated CSF hypovolemia after microsurgical aneurysmal clipping for subarachnoid hemorrhage (SAH)., Method: This study included 144 consecutive patients with SAH. Lumbar drainage (LD) was inserted after general anesthesia or postoperatively as a standard perioperative protocol. CSF hypovolemia diagnosis was based on three criteria., Results: Eleven patients (7.6%) were diagnosed with CSF hypovolemia according to diagnostic criteria in a postoperative range of 0-8 days. In all patients, signs or symptoms of CSF hypovolemia improved within 24 hours by clamping LD and using the Trendelenburg position., Conclusions: As a cause of acute clinical deterioration after aneurysmal clipping, CSF hypovolemia is likely under-recognized, and may actually be misdiagnosed as vasospasm or brain swelling. We should always take the etiology of CSF hypovolemia into consideration, and especially pay attention in patients with pneumocephalus and subdural fluid collection alongside brain sag on computed tomography. These patients are at higher risk developing of pressure gradients between their cranial and spinal compartments, and therefore, brain sagging after LD, than after ventricular drainage. We should be vigilant to strictly manage LD so as not to produce high pressure gradients.
- Published
- 2013
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36. [A rare case of developmental venous anomaly with diffuse arteriovenous shunt in the posterior fossa presented as massive cerebellar hemorrhage].
- Author
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Fujimoto T, Kawahara I, Tsutsumi K, Matsunaga Y, Ono T, Takahata H, Toda K, and Baba H
- Subjects
- Arteriovenous Fistula complications, Arteriovenous Fistula diagnosis, Cerebral Angiography methods, Cerebral Hemorrhage diagnosis, Cerebral Hemorrhage etiology, Child, Diagnostic Imaging, Humans, Intracranial Arteriovenous Malformations complications, Intracranial Arteriovenous Malformations diagnosis, Male, Treatment Outcome, Arteriovenous Fistula surgery, Cerebral Hemorrhage surgery, Intracranial Arteriovenous Malformations surgery
- Abstract
Developmental venous anomalies(DVAs), that have been previously called venous malformation, are extreme variations of normal transmedullary veins that are necessary for the drainage of white and gray matter. They are becoming the most commonly encountered intracranial vascular lesions in central nervous system imaging. Most DVAs are asymptomatic or uncomplicated, and surgery is no longer considered necessary. The author describes a rare case of an 8-year-old patient presenting with massive cerebellar hemorrhage due to DVA with diffuse arteriovenous(A-V)shunt. Cerebral angiography demonstrated diffuse A-V shunt from the basilar artery runs into the bilateral basal vein of Rosenthal through the enlarged transpontine vein. Caput medusae-like appearance was visualized, although the finding of nidus was not obvious. Moreover, three-dimensional computed tomography angiography demonstrated stenosis in part of the drainage routes. Then, we supposed that this lesion was a transitional form between a DVA and an arteriovenous malformation, and massive cerebellar hemorrhage might be caused by secondary venous hypertension due to venous stenosis. A careful follow-up should be made, because the prognosis of DVA with A-V shunt has not been fully elucidated.
- Published
- 2013
37. [Rupture of an internal carotid-posterior communicating artery aneurysm formerly presented with transient pupil-sparing oculomotor nerve palsy in an extremely elderly patient].
- Author
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Mijin T, Tsutsumi K, Fujimoto T, Takahata H, Kawahara I, Ono T, Toda K, Baba H, and Yonekura M
- Subjects
- Aged, 80 and over, Carotid Artery, Internal diagnostic imaging, Embolization, Therapeutic, Female, Humans, Intracranial Aneurysm complications, Intracranial Aneurysm diagnostic imaging, Intracranial Aneurysm therapy, Oculomotor Nerve diagnostic imaging, Oculomotor Nerve Diseases diagnostic imaging, Radiography, Rupture complications, Rupture diagnostic imaging, Treatment Outcome, Carotid Artery, Internal pathology, Intracranial Aneurysm diagnosis, Oculomotor Nerve pathology, Oculomotor Nerve Diseases etiology, Pupil physiology
- Abstract
We recently encountered experienced a rare case of transient pupil-sparing oculomotor nerve palsy(PSONP)caused by an aneurysm at the junction of the internal carotid-and posterior communicating arteries(IC/PC AN)in an 87-year-old, non-diabetic woman. She initially presented with diplopia 4 years previously, and was diagnosed, based on incomplete right oculomotor paresis without pupil involvement(PSONP), as external ophthalmoplegia. MR-angiography revealed a long protrusion of the IC/PC AN with posterior-inferior projection, for which she chose to receive conservative management. Thirty nine months later, she presented with another transient PSONP. CT angiography(CTA)showed that the aneurysm was enlarged in the posterior-inferior direction. Two days after this last CTA imaging, the aneurysm ruptured with upward enlargement of the bleb. Despite complete external ophthalmoplegia and ptosis, her pupil involvement was still minimal and transient. By reviewing reported cases and our own case, we found that a narrow and long aneurysm body and posterior-inferior projection are characteristic for the IC/PC AN that causes PSONP, implying a possible mechanism for PSONP by upward compression of the oculomotor nerve. Though rare in its incidence, IC/PC AN could present with PSONP prior to their rupture. Therefore, immediate imaging evaluation in patients presenting with PSONP is essential to prevent devastating rupture events.
- Published
- 2013
38. De novo ruptured aneurysm at the site of anastomosis after superficial temporal artery-middle cerebral artery anastomosis--case report and literature review.
- Author
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Kawahara I, Morofuji Y, Tsutsumi K, Takahata H, Ono T, Toda K, Baba H, and Yonekura M
- Subjects
- Aged, Aneurysm, Ruptured complications, Arterial Occlusive Diseases surgery, Carotid Stenosis surgery, Cerebral Hemorrhage etiology, Cerebral Infarction surgery, Humans, Intracranial Aneurysm complications, Magnetic Resonance Angiography, Magnetic Resonance Imaging, Male, Neurosurgical Procedures, Tomography, X-Ray Computed, Vascular Surgical Procedures, Vertebrobasilar Insufficiency surgery, Anastomosis, Surgical adverse effects, Aneurysm, Ruptured pathology, Cerebral Hemorrhage pathology, Intracranial Aneurysm pathology, Middle Cerebral Artery pathology, Middle Cerebral Artery surgery, Postoperative Complications pathology, Temporal Arteries pathology, Temporal Arteries surgery
- Published
- 2013
- Full Text
- View/download PDF
39. Peri-stent aneurysm formation following a stent implant for stenotic intracranial vertebral artery dissection: a technical report of two cases successfully treated with coil embolization.
- Author
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Ishimaru H, Nakashima K, Takahata H, and Matsuoka Y
- Subjects
- Constriction, Pathologic complications, Constriction, Pathologic surgery, Humans, Intracranial Aneurysm diagnostic imaging, Male, Middle Aged, Radiography, Treatment Outcome, Embolization, Therapeutic instrumentation, Embolization, Therapeutic methods, Intracranial Aneurysm etiology, Intracranial Aneurysm therapy, Stents adverse effects, Vertebral Artery Dissection complications, Vertebral Artery Dissection surgery
- Abstract
Introduction: Although stenting for stenotic vertebral artery dissection (VAD) improves compromised blood flow, subsequent peri-stent aneurysm (PSA) formation is not well-known. We report two cases with PSA successfully treated with coil embolization., Methods: Three patients with stenotic intracranial VAD underwent endovascular angioplasty at our institution because they had acute infarction in posterior circulation territory and clinical evidence of hemodynamic insufficiency. In two of three patients balloon angioplasty at first session failed to relieve the stenosis, and a coronary stent was implanted. Angiography immediately after stenting showed no abnormality in case 1 and minimal slit-like projection at proximal portion of the stent in case 2., Results: Angiography obtained 16 months after the stenting revealed PSA in case 1. In case 2, angiography performed 3 months later showed that the projection at proximal portion enlarged and formed an aneurysm outside the stent. Because follow-up angiographies showed growth of the aneurysm in both cases, endovascular aneurysmal embolization was performed. We advanced a microcatheter into the aneurysm through the strut of existing stent and delivered detachable coils into the aneurysm lumen successfully in both cases. The post-procedural course was uneventful, and complete obliteration of aneurysm was confirmed on angiography in both cases., Conclusion: Stenting for stenotic intracranial VAD may result in delayed PSA; therefore, follow-up angiographies would be necessary after stenting for stenotic intracranial arterial dissection. Coil embolization through the stent strut would be a solution for enlarging PSA.
- Published
- 2013
- Full Text
- View/download PDF
40. A facile synthesis of fully protected meso-diaminopimelic acid (DAP) and its application to the preparation of lipophilic N-acyl iE-DAP.
- Author
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Saito Y, Yoshimura Y, Wakamatsu H, and Takahata H
- Subjects
- Catalysis, Diaminopimelic Acid chemical synthesis, Esterification, Hydrophobic and Hydrophilic Interactions, Nod1 Signaling Adaptor Protein agonists, Oxidation-Reduction, Peptidoglycan chemistry, Diaminopimelic Acid analogs & derivatives
- Abstract
Synthesis of beneficial protected meso-DAP 9 by cross metathesis of the Garner aldehyde-derived vinyl glycine 1b with protected allyl glycine 2 in the presence of Grubbs second-generation catalyst was performed. Preparation of lipophilic N-acyl iE-DAP as potent agonists of NOD 1-mediated immune response from 9 is described.
- Published
- 2013
- Full Text
- View/download PDF
41. [Synthetic medicinal chemistry of the biomolecular components mimics].
- Author
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Takahata H
- Subjects
- Alkylation, Animals, Biomimetic Materials pharmacology, Biomimetic Materials therapeutic use, Diabetes Mellitus, Type 2 drug therapy, Enzyme Inhibitors pharmacology, Enzyme Inhibitors therapeutic use, Glycoside Hydrolase Inhibitors, Glycoside Hydrolases antagonists & inhibitors, Glycoside Hydrolases physiology, Glycosyltransferases antagonists & inhibitors, Glycosyltransferases physiology, Humans, Imino Pyranoses chemical synthesis, Imino Sugars pharmacology, Imino Sugars therapeutic use, Intestines enzymology, Stereoisomerism, Sucrase antagonists & inhibitors, alpha-Glucosidases physiology, Biomimetic Materials chemical synthesis, Enzyme Inhibitors chemical synthesis, Imino Sugars chemical synthesis
- Abstract
We are studying the medicinal synthetic chemistry of biomolecular component mimics such as carbohydrates, nucleosides, amino acids, and peptides. In this review, the synthesis and biological activities of iminosugars as carbohydrate mimics are discussed. Glycosidases and glycosyltransferases are involved in a wide range of anabolic and catabolic process, including digestion, the lysosomal catabolism of glycoconjugates, glycoprotein biosynthesis. Hence, modifying or blocking these processes in vivo using inhibitors is a topic of great interest from the therapeutic point of view. Iminosugars are sugars in which the endocyclic oxygen is replaced by a basic nitrogen atom. They are regarded as transition state mimics in certain types of enzyme reactions. This makes the field of iminosugars as carbohydrate mimics an exciting area of research. We synthesized all of the stereoisomers of polyhydroxypiperidines such as fagomine, 1-deoxynojirimycine, and isofagomine. In addition, their both enantiomers, as substrates for a variety of glycosidases were evaluated. Secondly, the asymmetric synthesis of α-1-C-alkyl-arabinoiminofuranoses was achieved by asymmetric allylic alkylation, RCM, and Negishi cross coupling as key reactions. Surprisingly, the L-forms showed a quite potent inhibitory activity toward rat intestinal maltase, while the activities of the D-forms were much weaker. Some of the prepared L-forms showed potent inhibitory activities towards intestinal maltase, with IC₅₀ values comparable to those of commercial drugs such as acarbose, voglibose, and miglitol, which are used in the treatment of type 2 diabetes. Among them, the inhibitory activity towards intestinal sucrase of α-1-C-L-butylarabinoiminofuranose was quite strong towards intestinal sucrase compared to the above commercial drugs.
- Published
- 2013
- Full Text
- View/download PDF
42. α-1-C-butyl-1,4-dideoxy-1,4-imino-l-arabinitol as a second-generation iminosugar-based oral α-glucosidase inhibitor for improving postprandial hyperglycemia.
- Author
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Kato A, Hayashi E, Miyauchi S, Adachi I, Imahori T, Natori Y, Yoshimura Y, Nash RJ, Shimaoka H, Nakagome I, Koseki J, Hirono S, and Takahata H
- Subjects
- Administration, Oral, Animals, Enzyme Inhibitors administration & dosage, Enzyme Inhibitors chemistry, Humans, Hypoglycemic Agents administration & dosage, Hypoglycemic Agents chemistry, Imino Sugars administration & dosage, Imino Sugars chemistry, Imino Sugars pharmacology, Inhibitory Concentration 50, Male, Mice, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, Enzyme Inhibitors therapeutic use, Glycoside Hydrolase Inhibitors, Hyperglycemia drug therapy, Hypoglycemic Agents therapeutic use, Imino Sugars therapeutic use
- Abstract
We report on the synthesis and the biological evaluation of a series of α-1-C-alkylated 1,4-dideoxy-1,4-imino-l-arabinitol (LAB) derivatives. The asymmetric synthesis of the derivatives was achieved by asymmetric allylic alkylation, ring-closing metathesis, and Negishi cross-coupling as key reactions. α-1-C-Butyl-LAB is a potent inhibitor of intestinal maltase, isomaltase, and sucrase, with IC50 values of 0.13, 4.7, and 0.032 μM, respectively. Matrix-assisted laser desorption ionization time-of-flight mass spectrometric analysis revealed that this compound differs from miglitol in that it does not influence oligosaccharide processing and the maturation of glycoproteins. A molecular docking study of maltase-glucoamylase suggested that the interaction modes and the orientations of α-1-C-butyl-LAB and miglitol are clearly different. Furthermore, α-1-C-butyl-LAB strongly suppressed postprandial hyperglycemia at an early phase, similar to miglitol in vivo. It is noteworthy that the effective dose was about 10-fold lower than that for miglitol. α-1-C-Butyl-LAB therefore represents a new class of promising compounds that can improve postprandial hyperglycemia.
- Published
- 2012
- Full Text
- View/download PDF
43. Dolichoectasic anterior cerebral artery and hemodynamics.
- Author
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Kawahara I, Morofuji Y, Takahata H, Toda K, Tsutsumi K, Baba H, and Yonekura M
- Subjects
- Anterior Cerebral Artery abnormalities, Anterior Cerebral Artery diagnostic imaging, Anterior Cerebral Artery pathology, Central Nervous System Vascular Malformations diagnosis, Cerebral Angiography methods, Cerebrovascular Disorders diagnosis, Diffusion Magnetic Resonance Imaging, Dilatation, Pathologic, Electroencephalography, Female, Humans, Predictive Value of Tests, Tomography, Emission-Computed, Single-Photon, Tomography, X-Ray Computed, Young Adult, Anterior Cerebral Artery physiopathology, Central Nervous System Vascular Malformations physiopathology, Cerebrovascular Circulation, Cerebrovascular Disorders physiopathology, Hemodynamics
- Abstract
Dolichoectasia of the intracranial arteries is a rare condition, and the vertebrobasilar system and the internal carotid artery are the most commonly involved structures. We report a rare case of idiopathic dolichoectasia of the anterior cerebral artery in a 22-year-old female. The patient caused an automobile accident and was brought to our hospital in an ambulance. A computed tomography scan and magnetic resonance imaging revealed no fresh lesions, but showed a prominent serpentine structure with calcification and flow void in the region of the interhemispheric fissure, which was suspicious for arteriovenous malformation or arteriovenous fistula. Cerebral angiography demonstrated extensive dilatation of the anterior cerebral artery, but no evidence of arteriovenous malformation or arteriovenous fistula. Single photon emission computed tomography revealed hypoperfusion of the right frontal lobe at rest. Electroencephalography showed no epileptic discharge. The patient's course was uneventful, and she was discharged with no neurologic deficit. There are few reports of hemodynamic changes in cases of dolichoectasia. In the diagnosis of cerebral dolichoectasia, cerebral hemodynamics should be examined carefully in addition to evaluating vascular disease by angiography., (Copyright © 2012 National Stroke Association. Published by Elsevier Inc. All rights reserved.)
- Published
- 2012
- Full Text
- View/download PDF
44. Recent advances in cyclonucleosides: C-cyclonucleosides and spore photoproducts in damaged DNA.
- Author
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Yoshimura Y and Takahata H
- Subjects
- Molecular Conformation, Nucleosides chemical synthesis, DNA Damage, DNA, Bacterial chemistry, Nucleosides chemistry, Spores, Bacterial chemistry
- Abstract
Cyclonucleosides which are fixed in a specific conformation around the glycosyl bond by a carbon and heteroatom chain constitute a unique category of nucleoside derivatives. Because they are structural analogs, cyclonucleosides and oligodeoxynucleotides containing them would be useful tools for investigating the biological functions and conformations of DNA, RNA as well as their steric interactions with proteins. C-Cyclonucleosides bridged by a carbon chain between the base and sugar moieties are the most attractive from the synthetic points of view as well as for use as biological tools. In this review, recent progress of the synthesis of C-cyclonucleosides is surveyed. Among the C-cyclonucleosides, 5',8-C-cyclodeoxyadenosine is one of the well-known derivatives of which the first practical synthesis was reported over 30 years ago. Recently, 5',8-C-cyclodeoxyadenosine has attracted considerable interest as a biomarker, since its formation in oxidatively-damaged DNA is considered to be related to various diseases and aging. Another important analogue of cyclonucleosides is a unique thymidine phosphate dimer, a so-called spore photoproduct, which has been found in photo-damaged DNA. Recent advances in the synthesis, mechanism-studies, and stereochemical preference of repairing enzymes related to 5',8-C-cyclodeoxyadenosine and spore photoproducts are also reviewed.
- Published
- 2012
- Full Text
- View/download PDF
45. [Spontaneous dissection of the anterior cerebral artery that simultaneously presented with cerebral infarction and subarachnoid hemorrhage, successfully treated with conservative management: a case report].
- Author
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Nanbara S, Tsutsumi K, Takahata H, Fujimoto T, Kawahara I, Ono T, Toda K, Baba H, and Yonekura M
- Subjects
- Aortic Dissection complications, Cerebral Infarction complications, Cerebral Infarction pathology, Follow-Up Studies, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Angiography, Magnetic Resonance Imaging, Male, Middle Aged, Subarachnoid Hemorrhage complications, Subarachnoid Hemorrhage pathology, Tomography, X-Ray Computed, Treatment Outcome, Aortic Dissection diagnosis, Anterior Cerebral Artery pathology, Cerebral Infarction therapy, Subarachnoid Hemorrhage therapy
- Abstract
We recently encountered a rare case of anterior cerebral artery dissection (ACAD) that accompanied fresh cerebral infarction (CI) and subarachnoid hemorrhage (SAH). An initial head CT showed a thin SAH in the interhemispheric cistern and cortical sulcus of the left frontal surface. Subsequent MRI performed 10 min after head CT scan revealed a fresh infarction in the left ACA region. MR-and digital subtraction angiograms demonstrated a dissection in the A2 portion of the left ACA with a leak of contrast media around the left A3 portion, suggesting that the bleeding occurred in a distal portion of the main dilation. Without anti-thrombotic therapy, the patient recovered without complications by blood pressure control and administration of brain-function protection therapies. We found 11 cases similar to the present case in the literature. All cases presented with lower-extremity dominant hemiparesis; however, sudden onset headache was rare. Blood pressure was not well-controlled in 4 out of the 6 known hypertensive cases. Main sites of dissection were located at the A2 portion in all cases except one A3 lesion, and extended to A3 in 2 cases. Conservative therapy led to favorable outcome in 8 cases, while 4 cases underwent surgical interventions for increasing risk of aneurysm rupture after initial observational therapies. Re-bleeding did not occur in any of the 12 cases reviewed. These data suggest that conservative treatment can be considered for an initial management of ACAD with simultaneous CI and SAH. More evidence needs to be accumulated to establish the optimal therapeutic approach for ACAD associated with CI and SAH.
- Published
- 2012
46. [Multiple cerebral metastasis of a retroperitoneal leiomyosarcoma].
- Author
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Kawahara I, Fujimoto T, Ono T, Takahata H, Toda K, Tsutsumi K, Baba H, Yonekura M, Ito M, and Mori K
- Subjects
- Female, Humans, Middle Aged, Brain Neoplasms secondary, Leiomyosarcoma pathology, Retroperitoneal Neoplasms pathology
- Abstract
A 61-year-old woman presented with dementia, 7 years after an operation for retroperitoneal leiomyosarcoma. Magnetic resonance imaging (MRI) revealed enhanced masses with perifocal edema in the bilateral frontal regions and a very small mass in the right medial frontal region. The tumors in the bilateral frontal regions were completely removed surgically, and γ-knife radiotherapy was administered for the very small tumor in the right medial frontal region. The histological diagnosis was metastatic leiomyosarcoma. Postoperatively, an MRI showed that the perifocal edemahad decreased, and the symptoms gradually improved. Cerebral metastasis from a retroperitoneal leiomyosarcoma is very uncommon. Ideally, the tumors should be surgically removed because radiotherapy and chemotherapy are apparently ineffective. A combination of complete surgical removal and γ-knife radiotherapy may be effective in prolonging patient survival.
- Published
- 2012
47. An alternative approach to para-C-H arylation of phenol: palladium-catalyzed tandem γ-arylation/aromatization of 2-cyclohexen-1-one derivatives.
- Author
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Imahori T, Tokuda T, Taguchi T, and Takahata H
- Subjects
- Catalysis, Molecular Structure, Cyclohexanones chemistry, Palladium chemistry, Phenol chemistry
- Abstract
An efficient approach to prepare para-aryl phenols has been developed by using a Pd-catalyzed tandem γ-arylation/aromatization of 2-cyclohexen-1-one derivatives with aryl bromides. This approach provides various p-aryl phenols from the phenol surrogates, 2-cyclohexen-1-one derivatives, in a single reaction step on the basis of C-H arylation.
- Published
- 2012
- Full Text
- View/download PDF
48. Shrinkage of a vertebral dissecting aneurysm after stent-assisted coil embolization demonstrated by the three-dimensional driven equilibrium sequence. Case report.
- Author
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Takahata H, Ishimaru H, Morofuji Y, Nakashima K, Tsutsumi K, Baba H, and Yonekura M
- Subjects
- Blood Vessel Prosthesis standards, Embolization, Therapeutic instrumentation, Humans, Male, Middle Aged, Stents standards, Vertebral Artery Dissection physiopathology, Embolization, Therapeutic methods, Imaging, Three-Dimensional methods, Magnetic Resonance Imaging methods, Neuronavigation methods, Vertebral Artery Dissection diagnosis, Vertebral Artery Dissection therapy
- Abstract
A 61-year-old man with a history of cerebellar infarction was transferred to our hospital for the treatment of vertebral artery (VA) stenosis. The VA dissection was treated with endovascular stent placement followed by coil embolization in which shrinkage of the dissecting aneurysm was confirmed by the three-dimensional driven equilibrium (3D DRIVE) sequence. Using 3D DRIVE, the outer contour of the aneurysm was well visualized, free from the influence of the metallic devices. 3D DRIVE may be useful in the follow-up assessment of the vertebrobasilar artery after stent-assisted coil embolization.
- Published
- 2012
- Full Text
- View/download PDF
49. Ruptured intracranial aneurysms in pediatric polyarteritis nodosa: case report.
- Author
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Toyoda K, Tsutsumi K, Hirao T, Ono T, Takahata H, Toda K, Baba H, Ito M, and Yonekura M
- Subjects
- Aneurysm, Ruptured pathology, Angiography, Digital Subtraction, Cerebral Arteries pathology, Cerebral Arteries surgery, Child, Craniotomy, Diagnosis, Differential, Female, Humans, Image Processing, Computer-Assisted, Imaging, Three-Dimensional, Magnetic Resonance Angiography, Neurologic Examination, Polyarteritis Nodosa pathology, Postoperative Complications diagnosis, Postoperative Complications surgery, Reoperation, Tomography, X-Ray Computed, Aneurysm, Ruptured diagnosis, Aneurysm, Ruptured surgery, Cerebellum blood supply, Frontal Lobe blood supply, Polyarteritis Nodosa diagnosis, Polyarteritis Nodosa surgery
- Abstract
Polyarteritis nodosa (PAN) is a rare, systemic necrotizing vasculitis of small and medium size arteries that leads to aneurysms in various organs. Aneurysms associated with PAN are common in visceral arteries, however, intracranial aneurysms are rare, especially in childhood. A pediatric patient with PAN developed serial hemorrhagic strokes from a ruptured superior cerebellar artery aneurysm (subarachnoid hemorrhage) and a de novo aneurysm of the frontoorbital artery (intracerebral hemorrhage) after 9 months. Patients with PAN who present with intracranial aneurysms are candidates for intervention even if the aneurysm is unruptured and still small, and close observation is needed to detect de novo aneurysms in patients with chronic history of PAN.
- Published
- 2012
- Full Text
- View/download PDF
50. Thoracoscopic surgery support system using passive RFID marker.
- Author
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Takahata H, Kojima F, Okada M, Sugiura T, Sato T, and Oshiro O
- Subjects
- Humans, Neoplasms surgery, Prostheses and Implants, Radio Frequency Identification Device methods, Thoracoscopy instrumentation, Thoracoscopy methods
- Abstract
This paper proposes a RFID based thoracoscopic surgery support system, which is capable of marking a tumor inside organ tissue. The marker composed of small RFID-tags is implanted in the vicinity of tumor found in the endoscopy test. In the thoracoscopic surgery operation for removing the tumor, an RFID detector determines the accurate position of the implanted RFID-tag markers by measuring the strength of the signal emitted from the target tag. Due to limitation in the size of RFID-tag, the proposed system employs a passive RFID. To activate the passive tag implanted in the organ tissue, this paper designs a saddle-shape efficient power supply antenna. A sensitive and frequency-selective receiver is then designed for detecting the weak signal from the tag. The feasibility test confirms that the proposed method is capable of determining the accurate location of RFID tags implanted in the patient's organ tissue.
- Published
- 2012
- Full Text
- View/download PDF
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