149 results on '"Okada, Kenji"'
Search Results
2. Pre-emptive Aortic Side Branch Embolization during Endovascular Aneurysm Repair Using the Excluder Stent-Graft System: A Prospective Multicenter study.
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Sasaki, Koji, Yamaguchi, Masato, Gentsu, Tomoyuki, Kawasaki, Ryota, Miyamoto, Naokazu, Uotani, Kensuke, Sakamoto, Noriaki, Fukuda, Tetsuya, Horinouchi, Hiroki, Taniguchi, Takanori, Mori, Takeki, Koda, Yojiro, Yamanaka, Katsuhiro, Takahashi, Hiroaki, Okada, Kenji, Watanabe, Toshitaka, Hayashi, Taro, Nomura, Yoshikatsu, Matsushiro, Keigo, and Ueshima, Eisuke
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To evaluate the effectiveness and safety of pre-emptive transcatheter arterial embolization (P-TAE) for aortic side branches (ASBs) to prevent Type 2 endoleaks (EL2) before endovascular aneurysm repair (EVAR) using the Excluder stent-graft system (Excluder). In this prospective, multicenter study, 80 patients (mean age, 79.1 years [SD ± 6.7]; 85.0% were men; mean aneurysmal sac diameter, 48.4 mm [SD ± 7.4]) meeting the eligibility criteria were prospectively enrolled from 9 hospitals. Before EVAR, P-TAE was performed to embolize the patent ASBs originating from the abdominal aortic aneurysm. Contrast-enhanced computed tomography (CT) was performed at 1 month and 6 months after EVAR. The primary endpoint was EL2 incidence at 6 months, and the secondary endpoints were aneurysmal sac diameter changes at 6 and 12 months, P-TAE outcomes, adverse events related to P-TAE, reintervention, and aneurysm-related mortality. All patients successfully underwent P-TAE without serious. Coil embolization was successful in 81.6% of ASBs. EL2 incidence at 6 months was identified in 18 of 70 (25.7%) patients. Aneurysmal sac diameter shrinkage (≥5 mm) was observed in 30.0% of patients at 6 months and in 40.9% at 12 months. Only 1 patient required reintervention for EL2 within 1 year of EVAR; aneurysm-related deaths were not observed. P-TAE for ASBs before EVAR using Excluder is a safe and effective strategy. It aids in achieving early aneurysmal sac shrinkage and reduces EL2 reintervention at 1 year after EVAR. [Display omitted] [ABSTRACT FROM AUTHOR]
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- 2024
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3. “Spike” in acute asthma exacerbations during enterovirus D68 epidemic in Japan: A nation-wide survey
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Korematsu, Seigo, Nagashima, Kengo, Sato, Yasunori, Nagao, Mizuho, Hasegawa, Shunji, Nakamura, Haruna, Sugiura, Shiro, Miura, Katsushi, Okada, Kenji, and Fujisawa, Takao
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- 2018
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4. Long-term Results of Valve-Sparing Aortic Root Replacement and Aortic Cusp Repair.
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Kubo, Sara, Tanaka, Aya, Omura, Atsushi, Tsunemi, Kotaro, Oka, Takanori, Okada, Kenji, and Okita, Yutaka
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Long-term results of valve-sparing aortic root replacement (VSRR) and aortic cusp repair for aortic regurgitation are unclear. VSRR by reimplantation was performed in 363 patients. Tricuspid aortic valve (TAV) and bicuspid aortic valve were found in 285 and 71 patients, respectively. Aortic cusp repair was performed in 268 patients. Of patients with TAV 129 had central plication of the Arantius node, 36 had free margin resuspension, and 71 had reinforcement. Mean follow-up was 71.4 months. Among TAV patients freedom from aortic valve reoperation at 10 and 15 years was 85.1% and 78.3%, respectively. Freedom from aortic valve reoperation at 10 years was lower in patients with cusp prolapse than without (77.4% vs 93.2%, P =.007). The overall freedom from more than mild aortic regurgitation at 10 and 15 years was 72.4% and 64.0%, respectively. It was also significantly greater in patients without cusp prolapse (78.4% vs 67.7%, P =.02). As for the cusp repair technique the freedom from aortic valve reoperation at 10 years was significantly better in patients who underwent only resuspension or reinforcement techniques compared with patients who underwent only central plication technique (100% vs 72.8%, P =.008). Long-term results of VSRR with aortic cusp repair were satisfactory. The resuspension technique appears to be useful for repairing aortic cusp prolapse in patients with TAV. [Display omitted] [ABSTRACT FROM AUTHOR]
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- 2024
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5. Comparative study of resistivity characteristics between transparent conducting AZO and GZO thin films for use at high temperatures
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Nomoto, Jun-ichi, Konagai, Manabu, Okada, Kenji, Ito, Tomoyuki, Miyata, Toshihiro, and Minami, Tadatsugu
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- 2010
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6. Influence of acute progressive hypoxia on cardiovascular variability in conscious spontaneously hypertensive rats
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Sugimura, Mitsutaka, Hirose, Yohsuke, Hanamoto, Hiroshi, Okada, Kenji, Boku, Aiji, Morimoto, Yoshinari, Taki, Kunitaka, and Niwa, Hitoshi
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- 2008
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7. Acute Kidney Injury Affects Mid-Term Outcomes of Thoracoabdominal Aortic Aneurysms Repair.
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Henmi, Soichiro, Okita, Yutaka, Koda, Yojiro, Yamanaka, Katsuhiro, Omura, Atsushi, Inoue, Takeshi, and Okada, Kenji
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The effect of acute kidney injury (AKI) on mid-term outcomes following thoracoabdominal aortic aneurysm (TAAA) repair is not well known. We hypothesized that postoperative AKI would reduce mid-term survival and aimed to analyze the effect of AKI on mid-term outcomes after TAAA repair. This retrospective study identified 294 consecutive TAAA repairs at Kobe University Hospital from October 1999 to March 2019. Patients with preexisting end-stage renal disease that required hemodialysis (n = 11) and patients who died intraoperatively (n = 2) were excluded. Finally, 281 patients were analyzed. AKI was defined according to Kidney Disease: Improving Global Outcomes guidelines (KDIGO) classification. Of the 281 patients, 178 (63.3%) developed AKI, of which 98 (34.9%) had mild, 34 (12.1%) had moderate, and 46 (16.4%) had severe AKI. Twenty-six patients (12.8%) required renal replacement therapy after surgery. Twenty-three in-hospital deaths (8.2%) were recorded, including 2 (0.7%) without AKI, 0 (0%) with mild AKI, 1 (0.4%) with moderate AKI, and 20 (7.1%) with severe AKI (p < .001). The 4-year survival was 91.9 ± 3.0% for no AKI, 91.3 ± 3.2% for mild AKI, 72.4 ± 8.5% for moderate AKI and 32.6 ± 7.4% for severe AKI (p < .001). Multivariable Cox-hazard regression analysis demonstrated that moderate and severe AKI, older age and emergency surgery were significant risk factors for mid-term survival. In patients undergoing TAAA repair, severe AKI was associated with an increase in in-hospital mortality and both moderate and severe AKI were negatively associated with mid-term survival. Preventing moderate/severe AKI may improve mid-term survival after TAAA repair. [ABSTRACT FROM AUTHOR]
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- 2022
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8. Excessively high systemic blood pressure in the early phase of reperfusion exacerbates early-onset paraplegia in rabbit aortic surgery
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Pokhrel, Bishow, Hasegawa, Tomomi, Izumi, So, Ohmura, Atsushi, Munakata, Hiroshi, Okita, Yutaka, and Okada, Kenji
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Rabbits -- Health aspects ,Blood pressure -- Health aspects ,Surgery -- Health aspects ,Medical colleges -- Health aspects ,Hypertension -- Health aspects ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2009.11.063 Byline: Bishow Pokhrel, Tomomi Hasegawa, So Izumi, Atsushi Ohmura, Hiroshi Munakata, Yutaka Okita, Kenji Okada Abbreviations: BP, blood pressure; MPO, myeloperoxidase; MTS, modified Tarlov scale; OD, optical density; SCI, spinal cord ischemia; SCR, spinal cord reperfusion; tc-MEP, transcranial motor-evoked potential; TUNEL, terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling Abstract: We have demonstrated that therapeutic augmentation of systemic blood pressure during spinal cord ischemia plays an important role in minimizing spinal cord injury in both experimental and clinical aortic surgery. However, there remain concerns that excessively high blood pressure during spinal cord reperfusion may aggravate the reperfusion injury. The purpose of this study is to investigate the effect of high blood pressure during spinal cord reperfusion on postoperative neurologic outcomes after aortic surgery in rabbits. Author Affiliation: Department of Surgery, Divisions of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan Article History: Received 2 September 2009; Revised 6 November 2009; Accepted 26 November 2009 Article Note: (footnote) Disclosures: None.
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- 2010
9. Augmentation of systemic blood pressure during spinal cord ischemia to prevent postoperative paraplegia after aortic surgery in a rabbit model
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Izumi, So, Okada, Kenji, Hasegawa, Tomomi, Omura, Atsushi, Munakata, Hiroshi, Matsumori, Masamichi, and Okita, Yutaka
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Blood pressure -- Health aspects ,Paraplegia -- Prevention ,Paraplegia -- Health aspects ,Hypertension -- Prevention ,Hypertension -- Health aspects ,Ischemia -- Prevention ,Ischemia -- Health aspects ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2009.08.038 Byline: So Izumi, Kenji Okada, Tomomi Hasegawa, Atsushi Omura, Hiroshi Munakata, Masamichi Matsumori, Yutaka Okita Abbreviations: BP, blood pressure; HBP, high blood pressure; LBP, low blood pressure; LLI, lower limb ischemia; MAP, mean arterial pressure; MTS, modified Tarlov scale; SBP, systemic blood pressure; SCBF, spinal cord blood flow; SCI, spinal cord ischemia; SSEP, somatosensory evoked potential; tc-MEP, transcranial motor evoked potential; TUNEL, terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling Abstract: Paraplegia from spinal cord ischemia remains an unresolved complication in thoracoabdominal aortic surgery, with high morbidity and mortality. This study investigated postoperative effects of systemic blood pressure augmentation during ischemia. Author Affiliation: Department of Surgery, Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan Article History: Received 12 May 2009; Revised 15 July 2009; Accepted 9 August 2009 Article Note: (footnote) Disclosures: None.
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- 2010
10. Renoprotective immunosuppression by pioglitazone with low-dose cyclosporine in rat heart transplantation
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Tanaka, Yosuke, Hasegawa, Tomomi, Chen, Zhi, Okita, Yutaka, and Okada, Kenji
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Heart -- Transplantation ,Immunotherapy ,Biological response modifiers ,Transforming growth factors ,Urea ,Cyclosporine ,Hypoglycemic agents ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2009.04.019 Byline: Yosuke Tanaka, Tomomi Hasegawa, Zhi Chen, Yutaka Okita, Kenji Okada Abbreviations: BUN, blood urea nitrogen; CsA, cyclosporine; IFN, interferon; IL, interleukin; PPAR, peroxisome proliferator-activated receptor; TGF, transforming growth factor; TUNEL, transferase-mediated dUTP-biotin nick end labeling Abstract: The peroxisome proliferator-activated receptor [gamma] activator pioglitazone has recently been reported to possess pleiotropic cardioprotective and renoprotective actions. We hypothesized that pioglitazone would reduce a dose of the immunosuppressant cyclosporine after heart transplantation, resulting in beneficial protective effects for both cardiac allografts and recipient kidneys. Author Affiliation: Department of Surgery, Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan Article History: Received 11 January 2009; Revised 18 March 2009; Accepted 22 April 2009 Article Note: (footnote) Supported by a Japan Heart Foundation research grant.
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- 2009
11. Sinus node dysfunction after repair of partial anomalous pulmonary venous connection
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Takahashi, Hiroaki, Oshima, Yoshihiro, Yoshida, Masahiro, Yamaguchi, Masahiro, Okada, Kenji, and Okita, Yutaka
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Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2007.12.039 Byline: Hiroaki Takahashi (a), Yoshihiro Oshima (b), Masahiro Yoshida (b), Masahiro Yamaguchi (c), Kenji Okada (a), Yutaka Okita (a) Abbreviations: ASD, atrial septal defect; PAPVC, partial anomalous pulmonary venous connection; RA, right atrium; SND, sinus node dysfunction; SVC, superior vena cava Abstract: Sinus node dysfunction is known as a major complication after repair of partial anomalous pulmonary venous connection. We retrospectively analyzed the results of the atrial wall flap technique compared with the results of patch repair or direct suturing in the intra-atrial tunnel technique. Author Affiliation: (a) Department of Surgery, Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan (b) Department of Cardiovascular Surgery, Kobe Children's Hospital, Kobe, Japan (c) Department of Cardiovascular Surgery, Akashi Medical Center, Kobe, Japan Article History: Received 7 September 2007; Revised 7 November 2007; Accepted 7 December 2007
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- 2008
12. The adverse effect of back-bleeding from lumbar arteries on spinal cord pathophysiology in a rabbit model
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Kawanishi, Yujiro, Okada, Kenji, Tanaka, Hiroshi, Yamashita, Teruo, Nakagiri, Keitaro, and Okita, Yutaka
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Arteries -- Analysis ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2006.10.066 Byline: Yujiro Kawanishi, Kenji Okada, Hiroshi Tanaka, Teruo Yamashita, Keitaro Nakagiri, Yutaka Okita Abbreviations: ANOVA, analysis of variance; CSF, cerebrospinal fluid; MTS, modified Tarlov scale; TUNEL, terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling Abstract: The purpose of this study was to evaluate the adverse effect of back-bleeding from the lumbar arteries on spinal cord pathophysiology in a rabbit model. Author Affiliation: Division of Cardiovascular, Thoracic, and Pediatric Surgery, Kobe University Graduate School of Medicine, Kobe City, Hyogo, Japan. Article History: Received 27 June 2006; Revised 6 October 2006; Accepted 18 October 2006
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- 2007
13. Surgical treatment for Kommerell's diverticulum
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Ota, Takeyoshi, Okada, Kenji, Takanashi, Shuichiro, Yamamoto, Shin, and Okita, Yutaka
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Diverticulum -- Care and treatment ,Genetic disorders -- Care and treatment ,Surgery ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2005.10.012 Byline: Takeyoshi Ota (a), Kenji Okada (a), Shuichiro Takanashi (b), Shin Yamamoto (c), Yutaka Okita (a) Abbreviations: ALSA, aberrant left subclavian artery; ARSA, aberrant right subclavian artery; LAA, left aortic arch; RAA, right aortic arch Abstract: Kommerell's diverticulum, which is a rare condition, is a congenital abnormality of the aortic arch. The strategy of surgical treatment for Kommerell's diverticulum has not been established. Author Affiliation: (a) Department of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe (b) Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo (c) Department of Cardiovascular Surgery, Kawasaki-Saiwai Hospital, Kawasaki, Japan Article History: Received 19 July 2005; Revised 9 September 2005; Accepted 7 October 2005
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- 2006
14. Expanded polytetrafluoroethylene conduits with curved and handsewn bileaflet designs for right ventricular outflow tract reconstruction.
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Matsushima, Shunsuke, Matsuhisa, Hironori, Wakita, Kohki, Tsujimoto, Takanori, Takagaki, Naohisa, Honda, Itsuro, Oshima, Yoshihiro, Kawanami, Osamu, and Okada, Kenji
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This study reviewed the application of curved and bileaflet designs to pulmonary expanded polytetrafluoroethylene conduits with diameters of 10 to 16 mm and characterized this conduit on in vitro experiment, including particle image velocimetry. All patients who received this conduit between 2010 and 2022 were evaluated. Three 16-mm conduits were tested in a circulatory simulator at different cardiac outputs (1.5-3.6 L/minute) and bending angles (130°-150°). Fifty consecutive patients were included. The median operative body weight was 8.4 kg (range, 2.6-12 kg); 10-, 12-, 14-, and 16-mm conduits were used in 1, 4, 6, and 39 patients, respectively. In 34 patients, the conduit was implanted in a heterotopic position. The overall survival rate was 89% at 8 years with 3 nonvalve-related deaths. There were 10 conduit replacements; 5 16-mm conduits (after 8 years) and 1 12-mm conduit (after 6 years) due to conduit stenosis, and the remaining 4 for reasons other than conduit failure. Freedom from conduit replacement was 89% and 82% at 5 and 8 years, respectively. Linear mixed-effects models with echocardiographic data implied that 16-mm conduits were durable with a peak velocity <3.5 m/second and without moderate/severe regurgitation until the patient's weight reached 25 kg. In experiments, peak transvalvular pressure gradients were 11.5 to 25.5 mm Hg, regurgitant fractions were 8.0% to 14.4%, and peak Reynolds shear stress in midsystolic phase was 29 to 318 Pa. Our conduits with curved and bileaflet designs have acceptable clinical durability and proven hydrodynamic profiles, which eliminate valve regurgitation and serve as a reliable bridge to subsequent conduit replacement. [Display omitted] [ABSTRACT FROM AUTHOR]
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- 2024
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15. Superior protection in orthotopic rat lung transplantation with cyclic adenosine monophosphate and nitroglycerin-containing preservation solution
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Kayano, Koichi, Toda, Koichi, Naka, Yoshifumi, Okada, Kenji, Oz, Mehmet C., and Pinsky, David J.
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Explosives ,Dextrose ,Glucose ,Transplantation of organs, tissues, etc. ,Coenzymes ,Cyclic adenylic acid ,Adenylic acid ,Nitric oxide ,Dextran ,Guanosine ,Permeability ,Cyclic guanylic acid ,Nitrogen compounds ,Health - Abstract
Byline: Koichi Kayano, Koichi Toda, Yoshifumi Naka, Kenji Okada, Mehmet C. Oz, David J. Pinsky Abstract: Background: Primary lung graft failure is common, and current lung preservation strategies are suboptimal. Because the decline in lung levels of cyclic adenosine monophosphate and cyclic guanosine monophosphate during preservation could enhance adhesiveness of endothelial cells for leukocytes as well as increase vascular permeability and vasoconstriction, we hypothesized that buttressing these levels by means of a preservation solution would significantly improve lung preservation. Methods: An orthotopic rat left lung transplantation model was used. Lungs were harvested from male Lewis rats and preserved for 6 hours at 4[degrees]C with (1) Euro-Collins solution (n = 8); (2) University of Wisconsin solution (n = 8); (3) low-potassium dextran glucose solution (n = 8); (4) Columbia University solution (n = 8), which contains a cyclic adenosine monophosphate analog (dibutyryl cyclic adenosine monophosphate) and a nitric oxide donor (nitroglycerin) to buttress cyclic guanosine monophosphate levels; or (5) Columbia University solution without cyclic adenosine monophosphate or nitroglycerin (n = 8). PaO2, pulmonary vascular resistance, and recipient survival were evaluated 30 minutes after left lung transplantation and removal of the nontransplanted right lung from the pulmonary circulation. Results: Among all groups studied, grafts stored with Columbia University solution demonstrated the highest Pa O2 (355 [+ or -] 25 mm Hg for Columbia University solution versus 95 [+ or -] 22 mm Hg for Euro-Collins solution, P < .01, 172 [+ or -] 55 mm Hg for University of Wisconsin solution, P < .05, 76 [+ or -] 15 mm Hg for low-potassium dextran glucose solution, P < .01, and 82 [+ or -] 25 mm Hg for Columbia University solution without cyclic adenosine monophosphate or nitroglycerin, P < .01) and the lowest pulmonary vascular resistances (1 [+ or -] 0.2 mm Hg acents mL.sup.-1 acents min.sup.-1 for Columbia University solution versus 12 [+ or -] 4 mm Hg acents mL.sup.-1 acents min.sup.-1 for Euro-Collins solution, P < .01, 9 [+ or -] 2 mm Hg acents mL.sup.-1 acents min.sup.-1 for University of Wisconsin solution, 14 [+ or -] 6 mm Hg acents mL.sup.-1 acents min.sup.-1 for low-potassium dextran glucose solution, P < .01, and 8 [+ or -] 2 mm Hg acents mL.sup.-1 acents min.sup.-1 for Columbia University solution without cyclic adenosine monophosphate and nitroglycerin). These functional and hemodynamic improvements provided by Columbia University solution were accompanied by decreased graft leukostasis and decreased recipient tumor necrosis factor [alpha] and interleukin 1[alpha] levels compared with the other groups. In toto, these improvements translated into superior survival among recipients of Columbia University solution-preserved grafts (100% for Columbia University solution, 37% for Euro-Collins solution, P < .01, 50% for University of Wisconsin solution, P < .05, 50% for low-potassium dextran glucose solution, P < .05, and 13% for Columbia University solution without cyclic adenosine monophosphate and nitroglycerin, P < .01). Conclusion: Nitroglycerin and cyclic adenosine monophosphate confer beneficial vascular effects that make Columbia University solution a superior lung preservation solution in a stringent rat lung transplantation model. (J Thorac Cardiovasc Surg 1999;118:135-44) Author Affiliation: College of Physicians and Surgeons of Columbia University, New York Article History: Received 28 September 1998; Revised 15 December 1998; Revised 5 March 1999; Accepted 8 March 1999 Article Note: (footnote) [star] Supported in part by the United States Public Health Service (grants RO1 HL55397 and RO1 HL59488). Dr Pinsky is a Clinician-Scientist of the American Heart Association, Dallas, Tex., [star][star] Address for reprints: David J. Pinsky, MD, Columbia University, College of Physicians and Surgeons, PH 10 Stem, 630 W, 168th St, New York, NY 10032. J Thorac Cardiovasc Surg 1999;118:135-44, a 12/1/98424
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- 1999
16. Effectiveness of four doses of pertussis vaccine during infancy diminished in elementary school age: A test-negative case-control study in Japan.
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Ohfuji, Satoko, Okada, Kenji, Mouri, Yoko, Mihara, Yuka, Ishii, Shigeki, Miyata, Akiko, Fujino, Motoko, Motomura, Chikako, Ito, Hiroaki, Ohta, Mitsuhiro, Kasahara, Yoshihito, Nakamura, Hideo, Hasui, Masaki, Yoshikawa, Tetsushi, Tanaka, Takaaki, Nakano, Takashi, Koshida, Rie, Araki, Kaoru, Hara, Megumi, and Hirota, Yoshio
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CASE-control method , *WHOOPING cough vaccines , *VACCINE effectiveness , *ELEMENTARY schools , *INFANTS , *SCHOOL children - Abstract
• A test-negative case-control study examined an effectiveness of pertussis vaccine. • 4 doses of vaccine provided a high effectiveness in subjects under 6 years of age. • Vaccine effectiveness declines with time passed since the fourth dose. • 4 doses of pertussis vaccine have no preventive effect for school-aged children. The Japanese national immunization program recommends that children receive 4 doses of acellular pertussis vaccine between 3 months and 2 years of age. Nevertheless, the number of pertussis cases is increasing in elementary school children aged 6–12 years. Therefore, a test-negative case-control study was conducted to assess the effectiveness of the pertussis vaccine program. Subjects included children aged ≥3 months who visited a collaborating hospital due to pertussis-specific cough between October 2017 and November 2019. All subjects underwent diagnostic tests for pertussis, and those diagnosed as positive were regarded as cases. Subjects diagnosed as pertussis-negative were classified as controls. Vaccination history was collected using a questionnaire administered to parents with reference to immunization records. Logistic regression models were employed to calculate the odds ratio (OR) and 95% confidence interval for laboratory-confirmed pertussis. Of 187 recruited subjects (120 cases and 67 controls), questionnaire responses were obtained for 145 subjects (95 cases and 50 controls). Compared with unvaccinated subjects, the vaccine effectiveness (VE) of 4 doses was 70% among all subjects and reached to 90% with marginal significance among subjects under 6 years of age. However, among school-aged subjects, the VE was not suggestive of protection against pertussis (VE: 8%). For vaccinees given 4 doses, the OR for developing pertussis increased significantly with longer duration since the fourth dose (compared with <4.5 years, OR of 6.0–8.2 years = 5.74; OR of ≥8.3 years = 3.88; P for trend by duration < 0.01). Effectiveness of administering 4 doses of pertussis vaccine during infancy decreases with time passed since the fourth dose. This regimen does not protect school-aged children against pertussis. [ABSTRACT FROM AUTHOR]
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- 2021
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17. Identification by transesophageal echocardiography of intramural hematoma and the site of aortic rupture
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Orihashi, Kazumasa, Sueda, Taijiro, Okada, Kenji, and Imai, Katsuhiko
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Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2007.11.058 Byline: Kazumasa Orihashi, Taijiro Sueda, Kenji Okada, Katsuhiko Imai Author Affiliation: Department of Cardiovascular Surgery, Hiroshima University Hospital, Hiroshima, Japan Article History: Received 13 November 2007; Accepted 26 November 2007
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- 2008
18. Opinion: Aortic Graft Infection-Any Guidelines or Just Surgeon's Experience Lines!
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Okita, Yutaka, Yamanaka, Katsuhiro, and Okada, Kenji
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Aggressive strategies for thoracic aortic graft infection, including resection of all infected tissues, in situ replacement with a rifampicin-bonded graft, and omental flap installation, resulted in improved survival. [ABSTRACT FROM AUTHOR]
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- 2019
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19. Reducing the posterior wall length by using a small endoventricular patch for ischemic mitral regurgitation
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Tanaka, Hiroshi, Okada, Kenji, Nakagiri, Keitaro, Kawanishi, Yujiro, Matsumori, Masamichi, and Okita, Yutaka
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Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2007.01.036 Byline: Hiroshi Tanaka, Kenji Okada, Keitaro Nakagiri, Yujiro Kawanishi, Masamichi Matsumori, Yutaka Okita Author Affiliation: Department of Cardiovascular, Thoracic, and Pediatric Surgery, Kobe University Hospital, Kobe, Japan. Article History: Received 3 December 2006; Revised 23 January 2007; Accepted 29 January 2007
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- 2007
20. Resection of malignant fibrous histiocytoma involving the thoracoabdominal aorta with staged emobolization of the intercostal arteries
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Matsumori, Masamichi, Maruo, Ayako, Tanaka, Hiroshi, Nakagiri, Keitaro, Yamashita, Teruo, Okada, Kenji, and Okita, Yutaka
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Surgery ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2006.04.015 Byline: Masamichi Matsumori, Ayako Maruo, Hiroshi Tanaka, Keitaro Nakagiri, Teruo Yamashita, Kenji Okada, Yutaka Okita Author Affiliation: Division of Cardiovascular, Thoracic, and Pediatric Surgery, Kobe University Graduate School Of Medicine, Kobe, Japan. Article History: Received 31 March 2006; Accepted 10 April 2006
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- 2006
21. A modified elephant trunk technique: The 3-fold elephant trunk technique
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Okada, Kenji, Sueda, Taijiro, Orihashi, Kazumasa, Imai, Katsuhiko, and Sato, Katsutoshi
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Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2005.08.011 Byline: Kenji Okada, Taijiro Sueda, Kazumasa Orihashi, Katsuhiko Imai, Katsutoshi Sato Author Affiliation: Department of Cardiovascular Surgery, Hiroshima University Hospital, Hiroshima, Japan
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- 2005
22. X-ray crystal structure analysis and atomic charges of color former and developer: 4 colored formers
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Okada, Kenji and Okada, Sachiko
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- 1999
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23. Reversible visceral ischemia detected by transesophageal echocardiography and near-infrared spectroscopy
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Orihashi, Kazumasa, Matsuura, Yuichiro, Sueda, Taijiro, Watari, Masanobu, and Okada, Kenji
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Infrared spectroscopy ,Ischemia ,Health - Abstract
Byline: Kazumasa Orihashi, Yuichiro Matsuura, Taijiro Sueda, Masanobu Watari, Kenji Okada Author Affiliation: Hiroshima Japan From the First Department of Surgery, Hiroshima University School of Medicine, Hiroshima, Japan Article History: Received 26 August 1999; Accepted 7 October 1999 Article Note: (footnote) [star] Address for reprints: Kazumasa Orihashi, MD, First Department of Surgery, Hiroshima University School of Medicine, Kasumi 1-2-3, Minami-ku, Hiroshima, 734-8551 Japan (E-mail: ka-ori@mcai.med.hiroshima-u.ac.jp) ., [star][star] J Thorac Cardiovasc Surg 2000;119:384-6, a 0022-5223/2000 $12.00 + 0 12/54/103601
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- 2000
24. Impending paradoxical embolism.
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Henmi, Soichiro, Nakai, Hidekazu, Yamanaka, Katsuhiro, Omura, Atsushi, Inoue, Takeshi, and Okada, Kenji
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An impending paradoxical embolism (IPDE) is seldom observed in clinical practice. We report a case of IPDE in a 67-year-old female with severe dyspnea and hypotension, which was detected and successfully treated with emergent cardiac surgery. The optimal treatment is still controversial. We believe that emergent surgery always should be considered in patients with IPDE. < Learning objective: We report a rare case of an impending paradoxical embolism in a 67-year-old female with severe dyspnea, which was successfully treated with emergent cardiac surgery. An emergent open surgery always should be considered in patients with impending paradoxical embolism.> [ABSTRACT FROM AUTHOR]
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- 2021
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25. Vaccination-associated acute disseminated encephalomyelitis.
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Torisu, Hiroyuki and Okada, Kenji
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POSTVACCINAL encephalitis , *VACCINATION , *DEMYELINATION , *INFLAMMATION , *INFECTION - Abstract
Abstract While the basic definition of vaccination-associated acute disseminated encephalomyelitis (ADEM) is relatively clear and easily understandable, it is often difficult to diagnose ADEM based on clinical findings alone. ADEM is actually a heterogeneous clinical syndrome that can be approximately characterized by encephalomyelitis with multiple inflammatory demyelination, autoimmune causes, and relationship with a preceding infection or vaccination. The differential diagnosis of ADEM should exclude the possibility of infectious or other autoimmune encephalitis. The occurrence of vaccination-associated ADEM is influenced by several factors including the health and ethnic status of the vaccinated individual, vaccine components, and environment. Cases suspected of vaccination-associated ADEM should be analyzed cautiously from multi-disciplinary perspectives. [ABSTRACT FROM AUTHOR]
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- 2019
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26. Impact of Frailty on Outcomes in Acute Type A Aortic Dissection.
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Gomibuchi, Toshihito, Seto, Tatsuichiro, Komatsu, Masaki, Tanaka, Haruki, Ichimura, Hajime, Yamamoto, Takateru, Ohashi, Noburo, Wada, Yuko, and Okada, Kenji
- Abstract
Background Although frailty is used to predict morbidity and mortality, its effect on the outcomes of acute type A aortic dissection has not been examined. Therefore, the objective of this study was to evaluate the role of frailty in predicting postoperative morbidity and mortality of patients with acute type A aortic dissection. Methods A retrospective analysis of a prospectively maintained database was undertaken for all patients (n = 310) undergoing aortic surgery between May 2004 and March 2017. Frailty was evaluated using an index consisting of age more than 70 years, body mass index less than 18.5 kg/m
2 , serum creatinine greater than 1.2 mg/dL, anemia, history of stroke, hypoalbuminemia, and the psoas muscle area index. One point was given for each criterion met, for a frailty score between 0 and 7. Frailty was defined as a score of 3 or more. Results Of all patients, 106 (34.2%) were defined as frail. Inhospital mortality rates of frail versus nonfrail patients were not significantly different (10.4% versus 8.3%, respectively; p = 0.54). Incidences of postoperative major morbidities without reexploration for bleeding were also not statistically different. Five-year survival rates were significantly worse for frail patients than for nonfrail patients (57.7% versus 85.1%, respectively; p = 0.0001). A frailty score of 3 or greater was associated with late mortality, and long-term outcomes were clearly stratified by frailty score. Conclusions Frailty, as defined using a seven-component frailty index, can serve as an independent predictor of the risk of late mortality for patients undergoing surgery for acute type A aortic dissection. Such frailty markers, all of which are easily assessed preoperatively, may provide valuable information for patient counseling and risk stratification before aortic surgery. [ABSTRACT FROM AUTHOR]- Published
- 2018
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27. Pioglitazone preserves vein graft integrity in a rat aortic interposition model
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Chen, Zhi, Hasegawa, Tomomi, Tanaka, Akiko, Okita, Yutaka, and Okada, Kenji
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Thiazolidinediones ,Actin ,Coronary artery bypass ,Muscle proteins ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2009.11.067 Byline: Zhi Chen, Tomomi Hasegawa, Akiko Tanaka, Yutaka Okita, Kenji Okada Abbreviations: CABG, coronary artery bypass grafting; MMP, matrix metalloproteinase; PPAR, peroxisome proliferator-activated receptor; SMA, smooth muscle actin; SMC, smooth muscle cell; TIMP, tissue inhibitor of matrix metalloproteinase Abstract: Improvement of vein graft patency may be highly beneficial in coronary artery bypass grafting, but graft degeneration is considered to be one of the main pathophysiologic causes for vein graft failure. Because peroxisome proliferator-activated receptor-[gamma] activator pioglitazone was recently reported to possess pleiotropic protective effects on various organs and tissues, we conducted experiments to test the hypothesis that pioglitazone could prevent graft degeneration, leading to the preservation of vein graft integrity. Author Affiliation: Department of Surgery, Division of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Japan Article History: Received 2 September 2009; Revised 10 November 2009; Accepted 27 November 2009 Article Note: (footnote) Disclosures: None., Supported by the Japan Heart Foundation Research Grant.
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- 2010
28. Aneurysm expansion caused by an intercostal type II endoleak after thoracic endovascular aortic repair for secondary elephant trunk graft fixation
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Kitagawa, Atsushi, Matsuda, Hitoshi, Okada, Kenji, and Okita, Yutaka
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Aneurysms ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2009.06.011 Byline: Atsushi Kitagawa, Hitoshi Matsuda, Kenji Okada, Yutaka Okita Author Affiliation: Division of Cardiovascular Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan Article History: Received 25 March 2009; Accepted 10 June 2009 Article Note: (footnote) Disclosures: None.
- Published
- 2010
29. Autologous fibrin-coated small-caliber vascular prostheses improve antithrombogenicity by reducing immunologic response
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Hasegawa, Tomomi, Okada, Kenji, Takano, Yoshihito, Hiraishi, Yoshiaki, and Okita, Yutaka
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Implants, Artificial ,Prosthesis ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2006.12.049 Byline: Tomomi Hasegawa, Kenji Okada, Yoshihito Takano, Yoshiaki Hiraishi, Yutaka Okita Abbreviations: ACD, acid-citrate-dextrose; A-graft, autologous fibrin-coated vascular prostheses; ANOVA, analysis of variance; ELISA, enzyme-linked immunosorbent assay; ICAM-1, intercellular adhesion molecule-1; NCS, newborn calf serum; NF[kappa]B, nuclear factor-kappa B; PAI-1, plasminogen activator inhibitor-1; PBS, phosphate-buffered saline; POD, postoperative day; SEM, scanning electron microscopic; tPA, tissue-type plasminogen activator; VCAM-1, vascular cell adhesion molecule-1; X-graft, xenologous fibrin-coated vascular prostheses Abstract: We have recently developed a thrombin-free fibrin-coated vascular prosthesis that has a high performance rate in producing graft antithrombogenicity. We hypothesized that autologous, compared with xenologous, fibrin coatings could improve the antithrombogenicity of grafts by reducing immunologic response. Author Affiliation: Division of Cardiovascular, Thoracic, and Pediatric Surgery, Department of Cardio-Pulmonary and Vascular Medicine, Kobe University Graduate School of Medicine, Kobe, and R & D Center, Terumo Corporation, Kanagawa, Japan. Article History: Received 3 June 2006; Revised 14 December 2006; Accepted 18 December 2006 Article Note: (footnote) Yutaka Okita reports grant support from Mitsubishi Pharma Research Foundation. Kenji Okada reports grant support from the Japan Society for the Promotion of Science.
- Published
- 2007
30. Safety and Efficacy of Intravenous Low-Dose Alteplase in Relative Contraindication Patients with Acute Ischemic Stroke.
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Ohta, Tsuyoshi, Okada, Kenji, Fukuda, Maki, Masahira, Noritaka, Matsuoka, Toshiki, Tsuno, Takaya, and Takemura, Mitsuhiro
- Abstract
Object: The purpose of this study was to investigate the safety and efficacy of intravenous low-dose alteplase for acute ischemic stroke patients with relative contraindications.Methods: The consecutive series of patients admitted within 4.5 hours of ischemic stroke onset between September 2012 and April 2017 were retrospectively evaluated. A good outcome at 90 days and symptomatic intracerebral hemorrhage were evaluated to determine the association with intravenous low-dose alteplase, especially in the presence of relative contraindications.Results: Intravenous low-dose alteplase was administered to 219 of 315 patients (70%). A significantly higher number of patients treated with intravenous low-dose alteplase achieved a good outcome compared with those treated without alteplase (60% versus 44%; P = .014). The incidence of symptomatic intracerebral hemorrhage was not significantly different between the treatment groups. Multivariable logistic regression analysis of good outcome revealed that the significant independent factors were age of 81 years or older (odds ratio, .33; 95% confidence interval, .18-.60), National Institutes of Health Stroke Scale (NIHSS) of 4 or less (compared with NIHSS, 5-25; odds ratio, 3.3; 95% confidence interval, 1.8-6.4), modified Rankin scale score of 1 before stroke (odds ratio, .32; 95% confidence interval, .14-.73), and large changes on first brain imaging (odds ratio, .16; 95% confidence interval, .058-.44). Even with these relative contraindications, intravenous low-dose alteplase was still associated with good outcome (odds ratio, 3.1; 95% confidence interval, 1.6-5.8).Conclusions: Intravenous low-dose alteplase treatment can be safe and effective in relative contraindication patients with acute ischemic stroke. [ABSTRACT FROM AUTHOR]- Published
- 2018
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31. Control selection and confounding factors: A lesson from a Japanese case-control study to examine acellular pertussis vaccine effectiveness.
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Ohfuji, Satoko, Okada, Kenji, Nakano, Takashi, Ito, Hiroaki, Hara, Megumi, Kuroki, Haruo, and Hirota, Yoshio
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VACCINE effectiveness , *WHOOPING cough vaccines , *DPT vaccines , *CONFIDENCE intervals , *STEROIDS , *PATHOGENIC microorganisms - Abstract
When using a case-control study design to examine vaccine effectiveness, both the selection of control subjects and the consideration of potential confounders must be the important issues to ensure accurate results. In this report, we described our experience from a case-control study conducted to evaluate the effectiveness of acellular pertussis vaccine combined with diphtheria-tetanus toxoids (DTaP vaccine). Newly diagnosed pertussis cases and age- and sex-matched friend-controls were enrolled, and the history of DTaP vaccination was compared between groups. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of vaccination for development of pertussis. After adjustment for potential confounders, four doses of DTaP vaccination showed a lower OR for pediatrician-diagnosed pertussis (OR = 0.11, 95% CI, 0.01–0.99). In addition, the decreasing OR of four doses vaccination was more pronounced for laboratory-confirmed pertussis (OR = 0.07, 95%CI, 0.01–0.82). Besides, positive association with pertussis was observed in subjects with a history of steroid treatment (OR = 5.67) and those with a recent contact with a lasting cough (OR = 4.12). When using a case-control study to evaluate the effectiveness of vaccines, particularly those for uncommon infectious diseases such as pertussis, the use of friend-controls may be optimal due to the fact that they shared a similar experience for exposure to the pathogen as the cases. In addition, to assess vaccine effectiveness as accurately as possible, the effects of confounding should be adequately controlled with a matching or analysis technique. [ABSTRACT FROM AUTHOR]
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- 2017
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32. Compressed true lumen in the innominate artery: A pitfall of right axillary arterial perfusion in acute aortic dissection
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Orihashi, Kazumasa, Sueda, Taijiro, Okada, Kenji, and Takahashi, Shinya
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Surgery ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2008.02.008 Byline: Kazumasa Orihashi, Taijiro Sueda, Kenji Okada, Shinya Takahashi Author Affiliation: Hiroshima University Hospital, Hiroshima, Japan Article History: Received 3 January 2008; Accepted 7 February 2008
- Published
- 2009
33. Reverse diastolic flow in the common carotid artery in severe aortic regurgitation, causing brain ischemia
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Morimoto, Naoto, Morimoto, Keisuke, Morimoto, Yoshihisa, Sakamoto, Toshihito, Matsumori, Masamichi, Okada, Kenji, and Okita, Yutaka
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Ischemia ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2008.01.010 Byline: Naoto Morimoto, Keisuke Morimoto, Yoshihisa Morimoto, Toshihito Sakamoto, Masamichi Matsumori, Kenji Okada, Yutaka Okita Author Affiliation: Division of Cardiovascular Surgery, University of Kobe, Kobe, Japan Article History: Received 19 December 2007; Accepted 15 January 2008
- Published
- 2008
34. Feasibility of preservation of subvalvular apparatus in mitral valve replacement with the On-X mechanical valve
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Tanaka, Hiroshi, Yamshita, Teruo, Okada, Kenji, Nakagiri, Keitaro, Kawanishi, Yujiro, and Okita, Yutaka
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Heart valve diseases ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2006.08.030 Byline: Hiroshi Tanaka, Teruo Yamshita, Kenji Okada, Keitaro Nakagiri, Yujiro Kawanishi, Yutaka Okita Author Affiliation: Kobe University Hospital, Department of Cardiovascular, Thoracic, and Pediatric Surgery, Kobe, Japan. Article History: Received 15 July 2006; Accepted 8 August 2006
- Published
- 2006
35. Pathologic features of cryopreserved aortic allograft implanted in the active infection
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Yamada, Akitoshi, Okada, Kenji, Takahashi, Rei, and Okita, Yutaka
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Transplantation of organs, tissues, etc. -- Health aspects ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2006.02.029 Byline: Akitoshi Yamada (a), Kenji Okada (a), Rei Takahashi (b), Yutaka Okita (a) Author Affiliation: (a) Division of Cardiovascular, Thoracic and Pediatric Surgery, Department of Cardio-Pulmonary and Vascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan (b) Department of Pathology and Tumor Biology, Kyoto University Graduate School of Medicine, Kyoto, Japan Article History: Received 25 January 2006; Accepted 6 February 2006
- Published
- 2006
36. Accessory mitral valve causing left ventricular outflow tract obstruction and mitral insufficiency
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Tanaka, Hiroshi, Okada, Kenji, Yamshita, Teruo, Nakagiri, Keitaro, Matsumori, Masamichi, and Okita, Yutaka
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Heart valve diseases ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2006.01.062 Byline: Hiroshi Tanaka, Kenji Okada, Teruo Yamshita, Keitaro Nakagiri, Masamichi Matsumori, Yutaka Okita Author Affiliation: Kobe University Hospital, Department of Cardiovascular, Thoracic, and Pediatric Surgery, Kobe, Japan Article History: Received 15 January 2006; Accepted 20 January 2006
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- 2006
37. Aortic valve replacement for a case of anomalous origin of the left coronary artery from posterior sinus of Valsalva with intramural aortic course
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Morimoto, Naoto, Okita, Yutaka, Okada, Kenji, Yamashita, Teruo, and Matsumori, Masamichi
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Heart valve diseases ,Health - Abstract
To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jtcvs.2005.08.003 Byline: Naoto Morimoto, Yutaka Okita, Kenji Okada, Teruo Yamashita, Masamichi Matsumori Author Affiliation: Division of Cardiovascular, Thoracic, and Pediatric Surgery, Kobe University Graduate School of Medicine, Kobe, Japan Article History: Received 3 July 2005; Accepted 3 August 2005
- Published
- 2005
38. Endogenous superoxide dismutase activation by oral administration of riboflavin reduces abdominal aortic aneurysm formation in rats.
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Yu, Zhenhai, Morimoto, Keisuke, Yu, Jie, Bao, Wulan, Okita, Yutaka, and Okada, Kenji
- Abstract
Objective Vitamin B 2 (riboflavin) reportedly has an antioxidant effect through superoxide dismutase (SOD) activation. However, the effect of riboflavin on abdominal aortic aneurysm (AAA) has never been investigated. In the present study, we examined the hypothesis that riboflavin has a protective effect on AAA formation in an experimental rat model. Methods The AAA model, which was induced with intraluminal elastase and extraluminal calcium chloride, was created in 36 rats. The 36 rats were divided into a riboflavin group (group R; 25 mg/kg/d), and control group (carboxymethyl cellulose). Riboflavin administration by gastric gavage once per day was started at 3 days before aneurysm preparation. On day 3, SOD activity in aneurysm walls was assayed. On day 7, reactive oxygen species (ROS) levels were semiquantified by dihydroethidium staining, and the oxidation product of DNA produced by ROS, 8-hydroxydeoxyguanosine (8-OHdG), was measured by immunohistochemical staining. Histopathologic examination (hematoxylin/eosin and elastica Van Gieson staining) was performed on day 28, and the AAA dilatation ratio was calculated to evaluate the protective effect of riboflavin. Results On day 3, SOD activity was significantly increased in aneurysm walls by riboflavin administration (370 ± 204 U/mL in normal, 334 ± 86 U/mL in control, 546 ± 143 U/mL in group R; P = .021). On day 7, ROS levels and 8-OHdG-positive cells in aneurysm walls were significantly decreased by riboflavin treatment (ROS levels: 1.0 ± 0.1 in normal, 4.5 ± 0.4 in control, 3.1 ± 0.5 in group R, P < .01; 8-OHdG-positive cells: 30 ± 2 cells in normal, 148 ± 20 cells in control, 109 ± 15 cells in group R, P < .01). Riboflavin treatment significantly reduced matrix metalloproteinase (MMP)-9 messenger RNA expression in aneurysm walls (relative expression: MMP-9: 0.4 ± 0.7 in normal, 2.6 ± 1.3 in control, 0.5 ± 0.3 in group R, P < .01). On day 28, the aortic walls were less dilated and had higher elastin content in group R than in control (dilatation ratio: 194.9% ± 10.9% in control, 158.6% ± 2.5% in group R; P <.01). Conclusions Riboflavin treatment prevents AAA formation in a rat model through an antioxidant effect and might be a potent pharmacologic agent for AAA treatment in clinical practice. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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39. Early and late outcomes of repaired acute DeBakey type I aortic dissection after graft replacement.
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Omura, Atsushi, Miyahara, Shunsuke, Yamanaka, Katsuhiro, Sakamoto, Toshihito, Matsumori, Masamichi, Okada, Kenji, and Okita, Yutaka
- Abstract
Objective The present study aimed to determine the impact of the extent of graft replacement on early and late outcomes in acute DeBakey type I aortic dissection. Methods Between October 1999 and July 2014, 197 consecutive patients were surgically treated for acute DeBakey type I aortic dissection. The extent of graft replacement (hemiarch, partial, or total arch replacement) was mainly determined by the location of the primary entry. Early and late results were compared in patients after total arch replacement (n = 88) and combined hemiarch and partial arch replacement: non–total arch replacement (n = 109). Results The in-hospital mortality rates of the total arch replacement and non–total arch replacement groups were 10.2% and 14.7%, respectively ( P = .47). Multivariate analysis revealed preoperative cardiopulmonary resuscitation and visceral organ malperfusion as significant risk factors for in-hospital mortality, but not total arch replacement. During a mean follow-up period of 60 ± 48 months, the 5-year survivals in the total arch replacement and non–total arch replacement groups were 88.6% ± 4.2% and 83.8% ± 4.4%, respectively ( P = .54). Rates of distal aortic events (defined as freedom from surgery for distal aorta dilation or distal arch diameter expanding to 50 mm) at 5 years were significantly better in the total arch replacement group than in the non–total arch replacement group (94.9% ± 3.5% vs 83.6% ± 4.9%, P = .01). Conclusions The operative mortality of patients with acute DeBakey type I aortic dissection treated by total arch replacement was acceptable with good long-term survival after both total arch replacement and non–total arch replacement. The frequency of distal aortic events might be reduced in patients after total arch replacement compared with non–total arch replacement. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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40. Mid-Term Results of Valve-Sparing Aortic Root Replacement in Patients With Expanded Indications.
- Author
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Miyahara, Shunsuke, Matsueda, Takashi, Izawa, Naoto, Yamanaka, Katsuhiro, Sakamoto, Toshihito, Nomura, Yoshikatsu, Morimoto, Naoto, Inoue, Takeshi, Matsumori, Masamichi, Okada, Kenji, and Okita, Yutaka
- Abstract
Background The mid-term results of valve-sparing aortic root reimplantation (VSRR) for various indications were investigated. Methods From 2000 to 2013, 183 consecutive patients undergoing VSRR were enrolled. Expanded indications, defined as a patient on the marginal operative indication, included age 65 years or older (n = 33), age 15 years or younger (n = 4), acute type A aortic dissection (AAAD) (n = 21), aortitis (n = 8), reoperative root replacement (n = 11), cusp prolapse (n = 67), large aortoventricular junction of greater than 28 mm (AVJ) (n = 42), preoperative severe aortic regurgitation (AR) (n = 89), left ventricular ejection fraction 0.40 or less (n = 12), LV dilation (n = 66), New York Heart Association class III or greater (n = 5), need for total arch replacement (n = 29), and concomitant mitral valve repair (n = 12). Results The overall survival at 5 years was 96.6%. Freedom from greater than mild AR and reoperation at 5 years was 85.8% and 92.9%, respectively. Cox proportional hazard model revealed that AAAD, cusp prolapse, AVJ 28 mm or greater, and operation before 2009 were at risk for late AR recurrence ( p = 0.015, p = 0.0041, p = 0.032, and p = 0.014, respectively). After 2009, freedom from late AR in the cusp prolapse group improved ( p = 0.055, versus control). Both freedom from recurrent AR and reoperation were worse as the number of expanded indications increased (log-rank trend p = 0.00017 and p = 0.00067, respectively). Conclusions Surgical outcomes of VSRR in these patient cohorts were satisfactory with some room for improvement in patients with cusp prolapse. Although the indications for VSRR are being expanded, a larger number of expanded indications were associated with poor outcomes in terms of longevity of valve function. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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41. Effectiveness of acellular pertussis vaccine in a routine immunization program: A multicenter, case-control study in Japan.
- Author
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Ohfuji, Satoko, Okada, Kenji, Nakano, Takashi, Ito, Hiroaki, Hara, Megumi, Kuroki, Haruo, and Hirota, Yoshio
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- *
WHOOPING cough vaccines , *IMMUNIZATION , *HEALTH programs , *DRUG efficacy , *MEDICAL records , *COMPARATIVE studies - Abstract
In 2008, the number of pertussis cases increased substantially among Japanese adolescents, despite high coverage with acellular pertussis vaccine (DTaP). This study examined the effectiveness of DTaP vaccine in the routine immunization program in Japan. Between April 2009 and October 2012, we conducted a multicenter, case-control study, and compared the history of DTaP vaccination between 55 newly diagnosed pertussis cases and 90 age- and sex-matched controls. DTaP vaccine history was obtained by a self-administered questionnaire completed by their parents or guardians. Logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of vaccination for development of pertussis. DTaP vaccination of ≥1 dose revealed a significantly lower OR for pertussis (OR = 0.20, 95%CI, 0.04–0.97), and the OR of complete vaccination (4 doses) was 0.22 (0.04–1.05). Even after limiting subjects to those whose vaccination status could be confirmed by the immunization records, the negative associations were observed. The decreasing ORs of 4-dose vaccinees remained, even among subjects who had received the fourth dose ≥9.2 years earlier (OR = 0.11, 95%CI, 0.01–1.02). In conclusion, DTaP vaccination had a preventive effect for pertussis. Effectiveness was observed even 9 or more years after the final dose. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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42. Influences of Chronic Obstructive Pulmonary Disease on Outcomes of Total Arch Replacement.
- Author
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Miyahara, Shunsuke, Nakai, Hidekazu, Izawa, Naoto, Yamanaka, Katsuhiro, Sakamoto, Toshihito, Nomura, Yoshikatsu, Inoue, Takeshi, Matsumori, Masamichi, Okada, Kenji, and Okita, Yutaka
- Abstract
Background Although an association between chronic obstructive pulmonary disease (COPD) and adverse surgical outcomes has been proposed, the impact of COPD severity on postoperative outcomes remains unclear. Our objective was to analyze the prognostic implication of COPD severity on outcomes after total aortic arch replacement. Methods Between October 1999 and December 2012, 269 patients undergoing total arch replacement through median sternotomy, who were elective cases with preoperative spirometry records, were retrospectively reviewed. Patients were divided into four groups: control group, with ratio of forced expiratory volume of air in 1 second (FEV 1 ) to forced vital capacity (FVC) of 70% or greater; mild airflow obstruction, with FEV 1 /FVC ratio less than 70% and FEV 1 80% or greater of predicted; moderate airflow obstruction, FEV 1 /FVC ratio less than 70% and FEV 1 50% to 79% of predicted; severe airflow obstruction, FEV 1 /FVC ratio less than 70% and FEV 1 less than 50% of predicted. Symptoms of functional dyspnea and disability were also assessed. Multivariate logistic and Cox regression methods were used to determine if there was an independent association between COPD and short-term and long-term outcomes, respectively. Results The in-hospital mortality rate was 2.2% (6 of 269). A consistent trend of increasing frequency of postoperative respiratory complications with advanced airflow obstruction was noted. In multivariate analysis, in-hospital mortality (p = 0.022), incidence of respiratory complications (p = 0.021) and overall mortality ( p = 0.025) was significantly associated with the symptoms of COPD, respectively. Conclusions The severity of COPD as defined by spirometry and symptoms of functional dyspnea may be an important prognostic marker of patients undergoing total arch replacement. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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43. Reply from authors: We still have more to do in our life.
- Author
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Okita, Yutaka, Ikeno, Yuki, and Okada, Kenji
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- 2021
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44. A dehydromonocrotaline-induced pulmonary hypertension model in the beagle
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Okada, Morihito, Yamashita, Chojiro, Okada, Masayoshi, and Okada, Kenji
- Subjects
Hypertension ,Health - Abstract
Byline: Morihito Okada, Chojiro Yamashita, Masayoshi Okada, Kenji Okada Author Affiliation: Kobe, Japan Article Note: (footnote) [star] From the Department of Surgery, Division II, Kobe University School of Medicine, Kobe, Japan., [star][star] J THORAC CARDIOVASC SURG 1995; 110:546-7, a 0022-5223/95 $3.00 + 0, aa 12/54/62461
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- 1995
45. Controlled release of ascorbic acid from gelatin hydrogel attenuates abdominal aortic aneurysm formation in rat experimental abdominal aortic aneurysm model.
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Tanaka, Akiko, Hasegawa, Tomomi, Morimoto, Keisuke, Bao, Wulan, Yu, Jie, Okita, Yutaka, Tabata, Yasuhiko, and Okada, Kenji
- Abstract
Objective Abdominal aortic aneurysms (AAAs) are associated with oxidative stress and inflammatory response. We investigated the hypothesis that the known antioxidant ascorbic acid, which can also promote elastin and collagen production by smooth muscle cells, would prevent AAA formation in a rat model. Methods An intraluminal elastase and extraluminal calcium chloride-induced rat AAA model was used, and the animals were divided into three groups: control (group C, n = 18), the aorta wrapped with a saline-impregnated gelatin hydrogel sheet (group G, n = 18), and the aorta wrapped with a gelatin hydrogel sheet incorporating ascorbic acid (group A, n = 18). Wrapping of the sheet was completed at the end of treatment for AAA creation. The aortic dilatation ratio was measured, and aortic tissues were further examined for oxidative stress and oxidative DNA damage using biochemical and histologic techniques. Results Aortic dilatation at both 4 and 8 weeks was inhibited in group A (dilatation ratio [%] at 4 weeks: 186.2 ± 21.8 in group C, 152.3 ± 10.2 in group G, 126.8 ± 11.6 in group A; P < .0001; dilatation ratio [%] at 8 weeks: 219.3 ± 37.5 in group C, 194.0 ± 11.6 in group G, 145.7 ± 8.3 in group A; P = .0002). Elastin and collagen content were significantly preserved in group A (elastin, P = .0015; collagen, P < .0001). The messenger RNA expressions of matrix metalloproteinase (MMP)-9, monocyte chemotactic protein-1, interleukin-1β, and tissue necrosis factor-α ( P = .0024, P < .0001, P < .0001, and P < .0001, respectively) were downregulated in group A ( P = .0024), whereas tissue inhibitors of metalloproteinase (TIMP)-1 and TIMP-2 were both upregulated in group A (TIMP-1, P = .0014; TIMP-2, P < .0001). Gelatin zymography showed activities of pro-MMP-2, MMP-2, and MMP-9 were significantly suppressed in group C ( P < .0001 for each). Reactive oxygen species expression and 8-hydroxydeoxyguanosine and cluster of differentiation 68 staining were significantly suppressed in group A (reactive oxygen species expression, P < .0001; 8-hydroxydeoxyguanosine-positive cells, P < .0001; cluster of differentiation 68 positive cells, P < .0001). Conclusions Controlled release of ascorbic acid using gelatin hydrogel sheet-attenuated AAA formation through antioxidant and anti-inflammatory effect, regulation of MMP-2, TIMP-1, and TIMP-2, and preserving elastin and collagen in this animal model. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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46. Early patency rate and fate of reattached intercostal arteries after repair of thoracoabdominal aortic aneurysms.
- Author
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Omura, Atsushi, Yamanaka, Katsuhiro, Miyahara, Shunsuke, Sakamoto, Toshihito, Inoue, Takeshi, Okada, Kenji, and Okita, Yutaka
- Abstract
Objectives: The present study analyzes the early patency of intercostal artery reconstruction, using graft interposition and aortic patch anastomosis, and determines the fate of reattached intercostal arteries after repair of thoracoabdominal aortic aneurysms. Methods: We selected 115 patients (mean age, 63 ± 15 years; range, 19-83 years; male, n = 83) treated by thoracoabdominal aortic aneurysm repair with 1 or more reconstructed intercostal arteries at the Kobe University Graduate School of Medicine between October 1999 and December 2012. The intercostal arteries were reconstructed using graft interposition (n = 66), aortic patch anastomosis (n = 42), or both (n = 7). Results: The hospital mortality rate was 7.8% (n = 9). Eleven patients (9.6%) developed spinal cord ischemic injury (permanent, n = 6, transient, n = 5). The average number of reconstructed intercostal arteries per patient was 3.0 ± 1.5 (1-7), and 345 intercostal arteries were reattached. The overall patency rate was 74.2% (256/345) and that of aortic patch anastomosis was significantly better than that of graft interposition (90.8% [109/120] vs 65.3% [147/225], P < .01), but significantly worse for patients with than without spinal cord ischemic injury (51.9% [14/27] vs 76.1% [242/318], P = .01). There was no patch aneurysm in graft interposition during a mean of 49 ± 38 (range, 2-147) postoperative months, but aortic patch anastomosis including 4 intercostal arteries became dilated in 2 patients. Conclusions: Aortic patch anastomosis might offer better patency rates and prevent spinal cord ischemic injury compared with graft interposition. Although aneurysmal changes in intercostal artery reconstructions are rare, large blocks of aortic wall reconstruction should be closely monitored. [Copyright &y& Elsevier]
- Published
- 2014
- Full Text
- View/download PDF
47. Orally administered dipeptidyl peptidase-4 inhibitor (alogliptin) prevents abdominal aortic aneurysm formation through an antioxidant effect in rats.
- Author
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Bao, Wulan, Morimoto, Keisuke, Hasegawa, Tomomi, Sasaki, Naoto, Yamashita, Tomoya, Hirata, Kenichi, Okita, Yutaka, and Okada, Kenji
- Abstract
Objective: Dipeptidyl peptidase-4 (DPP-4) inhibitor, a novel antidiabetic drug, has a cardioprotective effect on ischemia-reperfusion injury through an antioxidant effect. However, the effect of DPP-4 inhibitor on aneurysm formation has not been investigated. We aimed to test the hypothesis that the DPP-4 inhibitor, alogliptin, attenuates vascular oxidative stress and thus inhibits abdominal aortic aneurysm (AAA) formation. Methods: AAAs were created with intraluminal elastase and extraluminal calcium chloride in 36 male rats. Rats were divided into three groups: a low dose of alogliptin group (group LD; 1 mg/kg/d), a high-dose group (group HD; 3 mg/kg/d), and a control group (group C, water). Alogliptin was administered by gastric gavage once daily beginning 3 days before surgery. On day 7 after aneurysm preparation, reactive oxygen species (ROS) expression was semiquantified by dihydroethidium staining, and the oxidation product of DNA produced by ROS, 8-hydroxydeoxyguanosine (8-OHdG), was measured by immunohistochemical staining. Blood glucose concentrations were measured. Hematoxylin and eosin and elastica Van Gieson stainings were performed on day 28, and the AAA dilatation ratio was calculated. Results: On day 7 (six in each group), dihydroethidium staining of the aneurysm wall showed a reduced level of ROS expression (4.6 ± 0.6 in group C, 2.7 ± 0.3 in group LD, and 1.7 ± 0.5 in group HD; P < .0001) and showed fewer 8-OHdG-positive cells in alogliptin-treated samples (138.1 ± 7.4 cells in group C, 102.5 ± 4.5 cells in group LD, and 66.1 ± 4.5 cells in group HD; P < .0001) The treatment significantly reduced messenger RNA expression of matrix metalloproteinases (MMPs) in aneurysm walls (relative expression: MMP-2: 2.1 ± 0.4 in group C, 1.3 ± 0.3 in group LD, and 0.9 ± 0.2 in group HD; P < .001; MMP-9: 2.0 ± 0.5 in group C, 0.3 ± 0.3 in group LD, and 0.3 ± 0.2 in group HD; P < .001). On day 28 (six in each group), the aortic wall in groups LD and HD was less dilated (dilatation ratio: 199.2% ± 11.8% in group C, 159.6% ± 2.8% in group LD, and 147.1% ± 1.9% in group HD; P < .02 group C vs HD) and had higher elastin content than in group C. The difference in blood glucose levels among the three groups was not significant. Conclusions: The DPP-4 inhibitor, alogliptin, attenuates aneurysm formation and expansion dose-dependently in a rat AAA model via an antioxidative action. [Copyright &y& Elsevier]
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- 2014
- Full Text
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48. The Model for End-Stage Liver Disease (MELD) Predicts Early and Late Outcomes of Cardiovascular Operations in Patients With Liver Cirrhosis.
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Morimoto, Naoto, Okada, Kenji, and Okita, Yutaka
- Abstract
Background: We aimed to evaluate the severity of cirrhosis as a predictor of early and late outcomes after cardiovascular operations. Methods: We retrospectively reviewed patients who underwent cardiovascular operations in our institute between October 1999 and April 2009. The severity of liver cirrhosis was assessed using the Child-Pugh classification and the Model for End-stage Liver Disease (MELD) score. Results: Liver cirrhosis was identified in 32 consecutive patients. Averages of Child-Pugh and MELD scores were 7.2 ± 1.9 and 11.5 ± 5.1, respectively: 14 patients were classified as Child-Pugh class A, 14 as class B, and 4 as class C. The MELD score was less than 10 (category 1) in 10 patients, between 10 and 14.9 (category 2) in 14, and 15 or higher (category 3) in 8. The hospital mortality rate was 16% (5 of 32). Hospital mortality increased significantly as the MELD score category increased: category 1, 0%; category 2, 7%; and category 3, 50% (p = 0.005). There was no significant association between hospital mortality and Child-Pugh classification: class A, 7%; class B, 21%; and class C, 0% (p = 0.60). Overall survival was 72% ± 8% at 5 years and 47% ± 13% at 10 years. The survival rate decreased significantly as the MELD score category increased (p = 0.004). No relationship was found between the Child-Pugh classification and long-term survival. Conclusions: Our results suggest that the MELD score is useful to predict hospital death and long-term survival after cardiac operations for patients with liver cirrhosis. [Copyright &y& Elsevier]
- Published
- 2013
- Full Text
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49. Early and Midterm Outcomes of Open Surgical Correction After Thoracic Endovascular Aortic Repair.
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Miyahara, Shunsuke, Nomura, Yoshikatsu, Shirasaka, Tomonori, Taketoshi, Hideto, Yamanaka, Katsuhiro, Omura, Atsushi, Sakamoto, Toshihito, Inoue, Takeshi, Minami, Hitoshi, Okada, Kenji, and Okita, Yutaka
- Subjects
THORACIC aorta ,ENDOVASCULAR surgery ,HEALTH outcome assessment ,SURGICAL diagnosis ,PATHOLOGY ,MEDICAL care ,SURGERY - Abstract
Background: We present a single center''s experience of secondary interventions after thoracic endovascular aortic repair (TEVAR). Methods: One hundred and forty-seven patients underwent TEVAR at our institution between 2000 and 2012. A total of 26 patients (19 male, mean age 68.4 ± 12.7 years), including 7 patients with primary TEVAR at other centers, underwent secondary interventions. The median interval to secondary intervention was 17.2 months (range, 0.22 to 36.1). The indications for secondary interventions included procedure-related dissection (n = 1), collapse of the endovascular device (n = 1), aortoesophageal fistula (n = 1), residual dissection (n = 3), and endoleaks causing dilation of the sac (n = 17) or aortic rupture (n = 3). Sixteen patients underwent open conversion including total arch replacement (n = 2), extensive replacement of the aortic arch or descending aorta (n = 10), and thoracoabdominal aortic replacement (n = 4). Second-time TEVAR was performed in the remaining 10 patients. Results: The in-hospital mortality rate was 11.5% (3 patients; 1 case of multiorgan failure after open conversion, and 1 case of mesenteric ischemia and 1 case of aortic rupture after second-time TEVAR). Postoperative stroke after second-time TEVAR occurred in 1 patient. The cumulative survival rate of the 26 patients was 80.0% ± 8.0% at 5 years after secondary intervention. Short proximal neck (p = 0.0036), steep angulation of landing zones (p = 0.033), and nonuse of commercially available devices (p = 0.011) were significantly correlated with incidence of TEVAR failure. Conclusions: Secondary surgical procedures after TEVAR can be performed with low mortality and morbidity, despite the precarious preoperative conditions and complex aortic pathologies of patients. [Copyright &y& Elsevier]
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- 2013
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50. Safety and immunogenicity of a freeze-dried, cell culture-derived Japanese encephalitis vaccine (Inactivated) (JEBIK®V) in children
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Okada, Kenji, Iwasa, Toshiaki, Namazue, Junko, Akechi, Masateru, and Ueda, Shigeharu
- Subjects
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CELL culture , *ENCEPHALITIS vaccines , *JUVENILE diseases , *DRUG dosage , *RANDOMIZED controlled trials , *DRUG side effects , *MEDICAL statistics - Abstract
Abstract: Freeze dried, cell culture-derived Japanese encephalitis vaccine (Inactivated) (JEBIK®V) is approved for a three-dose primary immunization followed by a one-dose booster immunization in Japan. We conducted a multicenter, double-blinded, randomized controlled trial of the safety and immunogenicity of the vaccine in 370 healthy children who received three doses of 5, 2.5 or 1.25μg of virus protein per 0.5mL formulation subcutaneously. Children received two doses of test vaccine 7–28 days apart followed by a dose 6–12 months after the second vaccination. The three-dose regimen showed a good safety profile with no serious vaccine-related adverse events. Fever and reactions at the injection site were common adverse reactions at each dose of vaccine. The seroconversion rates were 100%, 99.2% and 95.0% after two doses in the 5, 2.5 and 1.25μg groups, respectively, and 100.0% after three doses in all groups. The geometric mean titers were high for all three formulations after the second and third doses, with a very clear dose–response relationship. These results indicate that JEBIK®V is likely to be a useful vaccine. [Copyright &y& Elsevier]
- Published
- 2012
- Full Text
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