286 results on '"Shusuke Yagi"'
Search Results
2. A case of gastric adenocarcinoma with pyloric gland-type infiltrating submucosa
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Kaiho Hirata, Shusuke Yagi, Hideki Miyazaki, Kazuhiko Yamada, Naoki Akazawa, Naoki Enomoto, Kyoko Nohara, Chizu Yokoi, Toru Igari, and Norihiro Kokudo
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Immunohistochemical staining ,Gastric cancer ,Gastric adenocarcinoma with pyloric gland type ,Surgery ,RD1-811 - Abstract
Abstract Background The development of immunohistochemical staining has revealed that gastric adenocarcinoma with the gastric phenotype can be divided into the foveolar, fundic gland, and pyloric gland phenotypes. Gastric adenocarcinoma of the pyloric gland type is difficult to diagnose using biopsy because of its low atypia and rarity. Herein, we describe a case of gastric adenocarcinoma of the pyloric gland type that was diagnosed immunohistochemically after endoscopic resection. Case presentation A 67-year-old man was referred to our hospital for the diagnosis and treatment of a 30-mm elevated lesion on the lesser curvature side of the middle of the gastric body. Although four biopsies were performed, it was difficult to determine whether the lesion was benign or malignant. Therefore, endoscopic submucosal dissection was performed, and the presence of tumor cells infiltrating the submucosa with venous invasions was identified. Immunohistochemical staining revealed that the tumor cells were positive for MUC5AC and MUC6 and negative for Pepsinogen I and H + /K + -ATPase. From the above findings, he was diagnosed as having gastric adenocarcinoma with pyloric gland type. The patient underwent a laparoscopic distal gastrectomy and was discharged without any adverse events. Conclusions Gastric adenocarcinoma of the pyloric gland type is a rare disease, and endoscopic resection can serve as a viable diagnostic option for this condition when it is difficult to diagnose using biopsy. Immunohistochemical pathology images can aid in the diagnosis of gastric adenocarcinoma of the pyloric gland type.
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- 2024
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3. Sex differences in the association between epicardial adipose tissue volume and left atrial volume index
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Satoshi Yamaguchi, Minetaka Maeda, Kageyuki Oba, Gulinu Maimaituxun, Osamu Arasaki, Shusuke Yagi, Kenya Kusunose, Takeshi Soeki, Hirotsugu Yamada, Daiju Fukuda, Hiroaki Masuzaki, Masataka Sata, and Michio Shimabukuro
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Epicardial adipose tissue ,Left atrial volume index ,Sex difference ,Atrial fibrillation ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Sex disparities in the association between epicardial adipose tissue volume (EATV) and cardiovascular disease have been reported. The sex-dependent effects of EATV on left atrial (LA) size have not been elucidated. Methods Consecutive 247 subjects (median 65 [interquartile range 57, 75] years; 67% of men) who underwent multi-detector computed tomography without significant coronary artery disease or moderate to severe valvular disease were divided into two groups: patients with sinus rhythm (SR) or atrial fibrillation (AF). Sex differences in the association between the EATV index (EATVI) (mL/m2) and LA volume index (LAVI) in 63 SR (28 men and 35 women) and 184 AF (137 men and 47 women) patients were evaluated using univariate and multivariate regression analyses. Results In overall that includes both men and women, the relationship between EATVI and LAVI was not significantly correlated for patients with SR and AF. The relationship between EATVI and LAVI differed between men and women in both SR and AF groups. In SR patients, there was a positive relationship between EATVI and LAVI in men, but not in women. In contrast, in patients with AF, a negative relationship was found between EATVI and LAVI in women, whereas no association was found in men. Conclusions We evaluated sex differences in the association between EATVI and LAVI in patients with either SR or AF, and found a positive relationship in men with SR and a negative relationship in women with AF. This is the first report to evaluate sex differences in the relationship between EATVI and LAVI, suggesting that EAT may play a role, at least in part, in sex differences in the etiology of AF.
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- 2024
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4. Refractory gastrocutaneous fistula treated by two-stage surgery: a case report
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Yuji Kobayashi, Shusuke Yagi, Kazuhiko Yamada, Daiki Kato, Naoki Enomoto, Kyoko Nohara, and Norihiro Kokudo
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Gastrocutaneous fistula ,Enterocutaneous fistula ,Open abdomen management ,Gastrectomy ,Surgery ,RD1-811 - Abstract
Abstract Background Gastrocutaneous fistulas are a rare complication of enterocutaneous fistulas and can be caused by intestinal injury, infection, and anastomotic leakage. They are typically treated conservatively or endoscopically; however, for large or difficult-to-treat gastrocutaneous fistulas, surgical intervention is required. Herein, we present a case of a huge gastrocutaneous fistula that was successfully treated with a two-stage surgery performed using open abdomen management. Case presentation A 61-year-old man with a perforated gastric ulcer underwent omental filling as an emergency surgery. Post-operative leakage led the development of a 10-cm gastrocutaneous fistula. He was transferred to our hospital for the treatment of gastrocutaneous fistula. Furthermore, nutritional therapy was administered for dehydration, electrolyte abnormalities, metabolic acidosis, and acute kidney injury due to the high-output nature of the fistula. Moreover, owing to the intraperitoneal severe adhesion and poor nutritional status, two-stage surgery was planned. In the first stage, extensive dissection of the adhesions, distal gastrectomy reconstruction with Roux-en-Y anastomosis, and jejunostomy were performed. Furthermore, open abdomen management was conducted to check for the presence of unexpected complications due to extensive dissection of the adhesion and anastomotic leakage. Subsequently, in the second stage of the surgery, abdominal closure was performed on the 9th day after gastrectomy. Conclusion Open abdomen management may be effective for huge gastrocutaneous fistulas with extensive adhesions that require surgical intervention.
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- 2023
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5. Clinical effects of a selective urate reabsorption inhibitor dotinurad in patients with hyperuricemia and treated hypertension: a multicenter, prospective, exploratory study (DIANA)
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Atsushi Tanaka, Isao Taguchi, Itaru Hisauchi, Hisako Yoshida, Michio Shimabukuro, Hiroshi Hongo, Tetsuya Ishikawa, Toshiaki Kadokami, Shusuke Yagi, Masataka Sata, Koichi Node, and the DIANA study investigators
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Selective urate transporter 1 inhibitor ,Dotinurad ,Hyperuricemia ,Arterial stiffness ,Oxidative stress ,Medicine - Abstract
Abstract Introduction Dotinurad is a newer urate-lowering agent that selectively inhibits urate transporter 1 in the renal proximal tubule and increases urinary urate excretion. Currently, little is known about the clinical efficacies of dotinurad in patients with hyperuricemia and hypertension. The aim of this study was to assess the clinical effects of a selective urate reabsorption inhibitor dotinurad on serum uric acid (SUA) levels and relevant vascular markers in patients with hyperuricemia and treated hypertension. Methods This investigator-initiated, multicenter, prospective, single-arm, open-label, exploratory clinical trial in Japan enrolled patients with hyperuricemia and treated hypertension who received a 24-week dotinurad therapy (a starting dose at 0.5 mg once daily and up-titrated to 2 mg once daily). The primary endpoint was a percentage change in the SUA level from baseline to week 24. The secondary endpoints were cardiovascular and metabolic measurements, including changes in the cardio-ankle vascular index (CAVI) and derivatives of reactive oxygen metabolites (d-ROMs) concentration at week 24. Results Fifty patients (mean age 70.5 ± 11.0 years, with 76.0% being men, and mean SUA level 8.5 ± 1.2 mg/dL) were included in the analysis. The percentage change from baseline in the SUA level at week 24 was − 35.8% (95% confidence interval [CI] − 39.7% to − 32.0%, P
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- 2023
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6. Innate Immune System Regulated by Stimulator of Interferon Genes, a Cytosolic DNA Sensor, Regulates Endothelial Function
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Phuong Tran Pham, Oyunbileg Bavuu, Joo‐Ri Kim‐Kaneyama, Xiao‐Feng Lei, Takayuki Yamamoto, Kenichiro Otsuka, Kumiko Suto, Kenya Kusunose, Shusuke Yagi, Hirotsugu Yamada, Takeshi Soeki, Michio Shimabukuro, Glen N. Barber, Masataka Sata, and Daiju Fukuda
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diabetes ,endothelial function ,inflammation ,STING ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Sterile inflammation caused by metabolic disorders impairs endothelial function; however, the underlying mechanism by which hyperglycemia induces inflammation remains obscure. Recent studies have suggested that stimulator of interferon genes (STING), a key cytosolic DNA sensor in the innate immune system, contributes to the pathogenesis of inflammatory diseases. This study examines the role of the STING in endothelial dysfunction in streptozotocin‐induced diabetic mice. Methods and Results Injection of streptozotocin promoted the expression of STING and DNA damage markers in the aorta of wild‐type mice. Streptozotocin elevated blood glucose and lipid levels in both wild‐type and STING‐deficient mice, which showed no statistical differences. Genetic deletion of STING ameliorated endothelial dysfunction as determined by the vascular relaxation in response to acetylcholine (P
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- 2023
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7. Clinical course and decision‐making in heart failure by preload stress echocardiography: a preliminary study
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Kenya Kusunose, Hirotsugu Yamada, Yoshihito Saijo, Susumu Nishio, Yukina Hirata, Takayuki Ise, Koji Yamaguchi, Daiju Fukuda, Shusuke Yagi, Takeshi Soeki, Tetsuzo Wakatsuki, and Masataka Sata
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Echocardiography ,Diastolic dysfunction ,Heart failure ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Aims Abnormal left ventricular diastolic response to preload stress can be an early marker of heart failure (HF). The aim of this study was to assess clinical course in patients with HF with preserved ejection fraction (HFpEF) who underwent preload stress echocardiography. In the subgroup analysis, we assessed the prognosis of patients with unstable signs during preload stress classified by treatment strategies. Methods and results We prospectively conducted preload stress echocardiographic studies between January 2006 and December 2013 in 211 patients with HFpEF. Fifty‐eight patients had abnormal diastolic reserve during preload stress (unstable impaired relaxation: unstable IR). Of 58 patients with unstable IR, 19 patients were assigned to additional therapy by increased or additional therapy and 39 patients were assigned to standard therapy. Composite outcomes were prespecified as the primary endpoint of death and hospitalization for deteriorating HF. During a median period of 6.9 years, 19 patients (33%) reached the composite outcome. Unstable group with standard therapy had significantly shorter event‐free survival than stable group. Patients with uptitration of therapy had longer event‐free survival than those with standard therapy group after adjustment of laboratory data (hazard ratio, 0.20, 95% confidence interval, 0.05–0.90; P = 0.036); the 10 year event‐free survival in patients with and without uptitration of therapy was 93% and 51%, respectively (P = 0.023). Conclusions Patients with unstable sign had significantly shorter event‐free survival than patients with stable sign. After additional therapy, the prognosis of patients with unstable signs improved. This technique may impact decision‐making for improving their prognosis.
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- 2022
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8. Hemothorax due to a ruptured esophageal gastrointestinal stromal tumor: case report
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Shohei Ohki, Naoki Enomoto, Daiki Kato, Shusuke Yagi, Hitomi Wake, Kyoko Nohara, Hideki Miyazaki, Toru Igari, Norihiro Kokudo, and Kazuhiko Yamada
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Esophageal gastrointestinal stromal tumor ,GIST ,Hemothorax ,Posterior mediastinal tumor ,Tumor rupture ,Surgery ,RD1-811 - Abstract
Abstract Background Esophageal gastrointestinal stromal tumors (GISTs) are rare tumors of the gastrointestinal interstitium, and comprise less than 0.7% of all GISTs. The presentation of esophageal GIST is relatively benign, commonly characterized by symptoms of dysphagia and gastrointestinal bleed. On the contrary, it is highly unusual for these tumors to present as surgical emergencies. Case presentation Here, we describe a case of hemothorax secondary to the rupture of a massive (19 cm) esophageal GIST in a 79-year-old male. The patient presented with mild back pain, vomiting, and hypotension. A CT scan revealed significant mediastinal enlargement and left hemothorax. We conducted an emergency thoracotomy which revealed a 19 × 15 × 7 cm ruptured esophageal tumor that was bleeding profusely into the left thoracic cavity. Piecemeal resection without esophagectomy was performed to achieve hemostasis. Pathological evaluation of resected tissue confirmed the diagnosis of GIST. The patient was provided adjuvant imatinib therapy and remains progression-free at the 10-month follow-up. Conclusions To the best of our knowledge, this is the first reported case of life-threatening hemothorax caused by a ruptured esophageal GIST. Findings from this case may aid in the diagnosis and management of these rare tumors.
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- 2022
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9. Clinical clerkship students’ preferences and satisfaction regarding online lectures during the COVID-19 pandemic
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Shusuke Yagi, Daiju Fukuda, Takayuki Ise, Koji Yamaguchi, Kenya Kusunose, Muneyuki Kadota, Yutaka Kawabata, Tomomi Matsuura, Tomohiro Soga, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Shinji Kawahito, and Masataka Sata
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Clinical clerkship ,COVID-19 ,Online lectures ,Special aspects of education ,LC8-6691 ,Medicine - Abstract
Abstract Background The COVID-19 pandemic has caused an unprecedented disruption in medical education. Students and lecturers had to adapt to online education. The current study aimed to investigate the level of satisfaction and future preference for online lectures among clinical clerkship students and elucidated the factors that affect these outcomes. Methods We selected a sample of 114 medical students undergoing clinical clerkship during the COVID-19 pandemic. We conducted onsite lectures before the pandemic and online lectures after the outbreak. A survey was conducted, and the sample included students and 17 lecturers. The average scores of total satisfaction and future preference related to online lectures were computed. Results Students’ scores on total satisfaction with online lectures and their future preference were higher than those for onsite lectures. Scores on the ease of debating dimension were low and those on accessibility of lectures in online lectures were higher than those in onsite lectures. There was no difference between the two groups in the scores on the comprehensibility and ease of asking questions dimensions. Results of the multiple regression analysis revealed that accessibility determined total satisfaction, and future preference was determined by comprehensibility as well as accessibility. Contrary to students’ future preferences, lecturers favored onsite lectures to online ones. Conclusion Online lectures are an acceptable mode of teaching during the COVID-19 pandemic for students undergoing clinical clerkship. Online lectures are expected to become more pervasive to avoid the spread of COVID-19.
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- 2022
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10. Right-sided Bochdalek hernia in an adult with hepatic malformation and intestinal malrotation
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Naoki Enomoto, Kazuhiko Yamada, Daiki Kato, Shusuke Yagi, Hitomi Wake, Kyoko Nohara, Nobuyuki Takemura, Tomomichi Kiyomatsu, and Norihiro Kokudo
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Bochdalek hernia ,Adult ,Right-sided ,Hepatic malformation ,Intestinal malrotation ,Three-dimensional simulation ,Surgery ,RD1-811 - Abstract
Abstract Background Bochdalek hernia is a common congenital diaphragmatic defect that usually manifests with cardiopulmonary insufficiency in neonates. It is very rare in adults, and symptomatic cases are mostly left-sided. Diaphragmatic defects generally warrant immediate surgical intervention to reduce the risk of incarceration or strangulation of the displaced viscera. Case presentation A 47-year-old woman presented with dyspnea on exertion. Computed tomography revealed that a large part of the intestinal loop with superior mesenteric vessels and the right kidney were displaced into the right thoracic cavity. Preoperative three-dimensional (3D) simulation software visualized detailed anatomy of displaced viscera and the precise location and size of the diaphragmatic defect. She underwent elective surgery after concomitant pulmonary hypertension was stabilized preoperatively. The laparotomic approach was adopted. Malformation of the liver and the presence of intestinal malrotation were confirmed during the operation. The distal part of the duodenum, jejunum, ileum, colon, and right kidney were reduced into the abdominal cavity consecutively. A large-sized oval defect was closed with monofilament polypropylene mesh. No complications occurred postoperatively. Conclusion Symptomatic right-sided Bochdalek hernia in adults is exceedingly rare and is frequently accompanied by various visceral anomalies. Accurate diagnosis and appropriate surgical repair are crucial to prevent possible incarceration or strangulation. The preoperative 3D simulation provided comprehensive information on anatomy and concomitant anomalies and helped surgeons plan the operation meticulously and perform procedures safely.
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- 2021
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11. Antegrade slow pathway mapping of typical atrioventricular nodal reentrant tachycardia based on direct slow pathway capture
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Takeshi Tobiume, Ritsushi Kato, Tomomi Matsuura, Kazuhisa Matsumoto, Motoki Hara, Nobuyuki Takamori, Yoshio Taketani, Keisuke Okawa, Takayuki Ise, Kenya Kusunose, Koji Yamaguchi, Shusuke Yagi, Daijyu Fukuda, Hirotsugu Yamada, Tetsuzo Wakatsuki, Takeshi Soeki, Masataka Sata, and Kazuo Matsumoto
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antegrade slow pathway ,atrioventricular nodal reentrant tachycardia ,extrastimulation ,reset ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Abstract Background Radiofrequency (RF) ablation of typical atrioventricular nodal reentrant tachycardia (tAVNRT) is performed without revealing out the location of antegrade slow pathway (ASp). In this study, we studied a new electrophysiological method of identifying the site of ASp. Methods This study included 19 patients. Repeated series of very high‐output single extrastimulations (VhoSESts) were delivered at the anatomical slow pathway region during tAVNRT. Tachycardia cycle length (TCL), coupling interval (CI), and return cycle (RC) were measured and the prematurity of VhoSESts [ΔPM (= TCL – CI)] and the prolongation of RCs [ΔPL (= RC – TCL)] were calculated. Pacing sites were classified into two categories: (i) ASp capture sites [DSPC(+) sites], where two different RCs were shown, and ASp non‐capture sites [DSPC(‐) sites], where only one RC was shown. RF ablation was performed at DSPC(+) sites and/or sites with catheter‐induced mechanical trauma (CIMT) to ASp. Results DSPC(+) sites were shown in 13 patients (68%). RF ablation was successful in all patients without any degree of atrioventricular block nor recurrence. Total number of RF applications was 1.8 ± 1.1. Minimal distance between successful ablation sites and DSPC(+)/CIMT sites and His bundle (HB) electrogram recording sites was 1.9 ± 0.8 mm and 19.8 ± 6.1 mm, respectively. ΔPL of more than 92.5 ms, ΔPL/TCL of more than 0.286, and ΔPL/ΔPM of more than 1.565 could identify ASp with sensitivity of 100%, 91.1%, and 88.9% and specificity of 92.9%, 97.0%, and 97.6%, respectively. Conclusions Sites with ASp capture and CIMT were close to successful ablation sites and could be useful indicators of tAVNRT ablation.
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- 2021
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12. Impact of preoperative endoscopy for predicting treatment response and prognosis in patients with gastric cancer after neoadjuvant chemotherapy
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Yoshiaki Shoji, Souya Nunobe, Naoki Nishie, Shusuke Yagi, Rie Makuuchi, Satoshi Ida, Koshi Kumagai, Manabu Ohashi, Akiyoshi Ishiyama, Toshiyuki Yoshio, Toshiaki Hirasawa, Junko Fujisaki, and Takeshi Sano
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Background and study aims Response evaluation criteria in solid tumors (RECIST) have been the gold standard to preoperatively predict treatment response and prognosis in patients with gastric cancer (GC) after neoadjuvant chemotherapy (NAC); however, methods for patients without evaluable lesions by RECIST are not yet confirmed. The aim of this study was to assess the utility of preoperative endoscopy for predicting treatment response and prognosis in patients with GC after NAC. Patients and methods This retrospective study included 105 patients with initially resectable GC who underwent NAC followed by surgical treatment. Preoperative factors for predicting treatment response and survival outcomes were analyzed. Results The number of patients classified as responders using preoperative endoscopic assessment, RECIST, and postoperative pathological evaluation were 25 (23.8 %), 28 (26.7 %), and 18 (17.1 %), respectively. Forty-three patients (41 %) were classified as non-targeted disease only, and their treatment responses were not evaluable by RECIST. Multivariate analysis identified endoscopic response as an independent preoperative factor to predict postoperative histological treatment response (odds ratio = 4.556, 95 % CI = 1.169–17.746, P = 0.029). Endoscopic treatment response was the only independent preoperative predictive factor for overall survival (OS) (hazard ratio = 0.419, 95 % confidence interval (CI) = 0.206–0.849, P = 0.016). Further, endoscopic treatment response was available for 33 patients (76.7 %) with non-targeted disease only, which showed significantly different OS between endoscopic responders (80.0 %) and non-responders (43.5 %) (P = 0.025). Conclusions Endoscopic evaluation was an independent preoperative factor to predict treatment response and prognosis in patients with GC after NAC. Endoscopic assessment may be especially valuable for patients who could not be assessed by RECIST.
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- 2022
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13. Two cases of a perforated duodenal diverticulum after gastrectomy with Roux-en-Y reconstruction
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Shusuke Yagi, Satoshi Ida, Manabu Ohashi, Koshi Kumagai, Naoki Hiki, Takeshi Sano, and Souya Nunobe
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Perforated duodenal diverticulum ,Gastrectomy ,Roux-en-Y reconstruction ,Intraduodenal pressure ,Duodenal diverticulum ,Surgery ,RD1-811 - Abstract
Abstract Background What type of reconstruction procedure should be applied is one of the important issues in surgery for gastric cancer. We have several options for reconstruction procedure after distal gastrectomy. The Billroth II and Roux-en-Y reconstruction have a duodenal stump while the Billroth I does not have it, which is the biggest structural difference in these procedures. An increase in intraduodenal pressure due to the formation of duodenum stump occasionally causes severe complication such as duodenal stump leakage; however, a duodenal diverticulum perforation after the Roux-en-Y reconstruction has not yet been reported. Herein, we report two cases of a perforated duodenal diverticulum after gastrectomy with the Roux-en-Y reconstruction. Case presentation The first case was a 66-year-old man who presented to our hospital with an acute onset right-upper-quadrant abdominal pain. He had undergone laparoscopic distal gastrectomy with the Roux-en-Y reconstruction for the early gastric cancer 15 months before. A large periampullary diverticulum had been detected during the checkup before the gastrectomy. Abdominal contrast-enhanced CT showed a retroperitoneal fluid collection with gas present at the second part of the duodenum. Therefore, a perforated duodenal diverticulum with abdominal abscess was diagnosed, and an emergency laparotomy was performed. Pancreaticoduodenectomy was performed because of severe duodenal inflammation and surrounding tissue damage. The second case was a 52-year-old man who had undergone open distal gastrectomy for locally advanced gastric cancer. Multiple non-ampullary duodenal diverticula had also been identified during the preoperative checkup. On the 2nd postoperative day, he presented with a sudden-onset abdominal pain with peritoneal irritation signs, and intestinal fluid was identified through the intraperitoneal drainage tube placed in a suprapancreatic site during his previous gastrectomy. Therefore, an emergency laparotomy was performed. During laparotomy, a perforated diverticulum at the second part of the duodenum was detected. The perforated duodenum diverticulum was directly sutured with drainage of the retroperitoneal space. Conclusions It is necessary to recognize that the Roux-en-Y reconstruction after gastrectomy for gastric cancer patients with duodenal diverticulum might cause a perforation of the diverticulum.
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- 2019
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14. Impact of cancer on short-term in-hospital mortality after primary acute myocardial infarction
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Shusuke Yagi, Masataka Sata, Michikazu Nakai, Kenya Kusunose, Yuichiro Okushi, Takayuki Ise, Koji Yamaguchi, Daiju Fukuda, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Robert Zheng, Yoshihiro Okayama, and Yoko Sumita
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2021
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15. Cardiac reserve by 6-minute walk stress echocardiography in systemic sclerosis
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Shusuke Yagi, Masataka Sata, Kenya Kusunose, Miharu Arase, Sae Morita, Natsumi Yamaguchi, Yukina Hirata, Susumu Nishio, Yuichiro Okushi, Takayuki Ise, Takeshi Tobiume, Koji Yamaguchi, Daiju Fukuda, Hirotsugu Yamada, Takeshi Soeki, and Tetsuzo Wakatsuki
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objectives There is a high prevalence of left ventricular diastolic dysfunction (LVDD) in systemic sclerosis (SSc) which is associated with high mortality. Thus, early detection of LVDD could be important in management of SSc. We hypothesised that exercise echocardiography in SSc patients with normal resting haemodynamics may expose early phase LVDD, which could affect its prognosis, defined as cardiovascular death and unplanned hospitalisation for heart failure.Methods Between January 2014 and December 2018, we prospectively enrolled 140 patients with SSc who underwent 6-minute walk (6MW) stress echocardiographic studies with normal range of estimated mean pulmonary arterial pressure (mPAP) (1.4 mm Hg/L/min) and impaired pulmonary vascular reserve (ΔmPAP/ΔCO>3.0 mm Hg/L/min) had worse outcomes compared with those without these abnormalities (p
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- 2021
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16. Acute Hospital Mortality of Venous Thromboembolism in Patients With Cancer From Registry Data
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Yuichiro Okushi, Kenya Kusunose, Yoshihiro Okayama, Robert Zheng, Michikazu Nakai, Yoko Sumita, Takayuki Ise, Takeshi Tobiume, Koji Yamaguchi, Shusuke Yagi, Daiju Fukuda, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, and Masataka Sata
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cardio‐oncology ,mortality ,venous thromboembolism ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background The prognosis of patients with cancer‐venous thromboembolism (VTE) is not well known because of a lack of registry data. Moreover, there is also no knowledge on how specific types are related to prognosis. We sought to evaluate the clinical characteristics and outcomes of patients with cancer‐associated VTE, compared with a matched cohort without cancer using real‐world registry data of VTE. Methods and Results This study was based on the Diagnosis Procedure Combination database in the JROAD‐DPC (Japanese Registry of All Cardiac and Vascular Diseases and the Diagnosis Procedure Combination). Of 5 106 151 total patients included in JROAD‐DPC, we identified 49 580 patients who were first hospitalized with VTE from April 2012 to March 2017. Propensity score was estimated with a logistic regression model, with cancer as the dependent variable and 18 clinically relevant covariates. After propensity matching, there were 25 148 patients with VTE with or without cancer. On propensity score‐matched analysis with 25 148 patients with VTE, patients with cancer had higher total in‐hospital mortality within 7 days (1.3% versus 1.1%, odds ratio [OR], 1.66; 95% CI, 1.31–2.11; P
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- 2021
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17. Deleterious Effects of Epicardial Adipose Tissue Volume on Global Longitudinal Strain in Patients With Preserved Left Ventricular Ejection Fraction
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Gulinu Maimaituxun, Kenya Kusunose, Hirotsugu Yamada, Daiju Fukuda, Shusuke Yagi, Yuta Torii, Nao Yamada, Takeshi Soeki, Hiroaki Masuzaki, Masataka Sata, and Michio Shimabukuro
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epicardial fat ,global longitudinal strain (GLS) ,lipotoxicity ,echocardiography ,HFpEF (heart failure with preserved ejection fraction) ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: It is known that epicardial adipose tissue (EAT) volume is linked to cardiac dysfunction. However, it is unclear whether EAT volume (EATV) is closely linked to abnormal LV strain. We examined the relationship between EATV and global longitudinal strain (GLS), global circumferential strain (GCS), and global radial strain (GRS) in patients with preserved LV function.Methods: Notably, 180 consecutive subjects (68 ± 12 years; 53% men) underwent 320-slice multi-detector computed tomography coronary angiography and were segregated into coronary artery disease (CAD) (≥1 coronary artery branch stenosis ≥50%) and non-CAD groups. GLS, GCS, and GRS were evaluated by 2-dimensional speckle tracking in patients with preserved left ventricular (LV) ejection fraction (LVEF) ≥50%.Results: First, GLS, but not GRS and GCS, was lower in the high EATV group though the LVEF was comparable to the low EATV group. Frequency of GLS ≤18 was higher in the high EATV group. Second, multiple regression model showed that EATV, age, male sex, and CAD, were determinants of GLS. Third, the cutoff points of EATV were comparable (~116–117 mL) in both groups. The cutoff of EATV ≥116 showed a significant correlation with GLS ≤18 in overall subjects.Conclusions: Increasing EATV was independently associated with global longitudinal strain despite the preserved LVEF and lacking obstructive CAD. Our findings suggest an additional role of EAT on myocardial systolic function by impaired LV longitudinal strain.
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- 2021
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18. Effects of L-/N-Type Calcium Channel Blockers on Angiotensin II–Renin Feedback in Hypertensive Patients
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Yutaka Kawabata, Takeshi Soeki, Hiroyuki Ito, Tomomi Matsuura, Kenya Kusunose, Takayuki Ise, Koji Yamaguchi, Takeshi Tobiume, Shusuke Yagi, Daiju Fukuda, Hirotsugu Yamada, Tetsuzo Wakatsuki, Mitsuhiro Kitani, Kazuhiro Kawano, Yoshio Taketani, and Masataka Sata
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objectives. Cilnidipine, an L-/N-type calcium channel blocker (CCB), has unique organ-protective properties due to suppression of hyperactivity in the sympathetic nervous system and renin-angiotensin system (RAS). In this study, we hypothesized that cilnidipine might exert a renoprotective effect by suppressing the RAS. Methods. A total of 25 hypertensive patients receiving a RAS inhibitor were randomly assigned to a cilnidipine (n = 12) or amlodipine (n = 13) group. The effects of cilnidipine on proteinuria and angiotensin II–renin feedback were assessed. Results. After 6 months of treatment, both systolic and diastolic blood pressures were significantly reduced to a similar extent in both groups. The urine albumin-to-creatinine ratio was significantly lower in the cilnidipine group (p
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- 2020
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19. Use of Echocardiography and Heart Failure In-Hospital Mortality from Registry Data in Japan
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Kenya Kusunose, Yuichiro Okushi, Yoshihiro Okayama, Robert Zheng, Michikazu Nakai, Yoko Sumita, Takayuki Ise, Koji Yamaguchi, Shusuke Yagi, Daiju Fukuda, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, and Masataka Sata
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heart failure ,echocardiography ,mortality ,big data ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Echocardiography requires a high degree of skill on the part of the examiner, and the skill may be more improved in larger volume centers. This study investigated trends and outcomes associated with the use and volume of echocardiographic exams from a real-world registry database of heart failure (HF) hospitalizations. Methods: This study was based on the Diagnosis Procedure Combination database in the Japanese Registry of All Cardiac and Vascular Datasets (JROAD-DPC). A first analysis was performed to assess the trend of echocardiographic examinations between 2012 and 2016. A secondary analysis was performed to assess whether echocardiographic use was associated with in-hospital mortality in 2015. Results: During this period, the use of echocardiography grew at an average annual rate of 6%. Patients with echocardiography had declining rates of hospital mortality, and these trends were associated with high hospitalization costs. In the 2015 sample, a total of 52,832 echocardiograms were examined, corresponding to 65.6% of all HF hospital admissions for that year. We found that the use and volume of echocardiography exams were associated with significantly lower odds of all-cause hospital mortality in heart failure (adjusted odds ratio (OR): 0.48 for use of echocardiography and 0.78 for the third tertile; both p < 0.001). Conclusions: The use of echocardiography was associated with decreased odds of hospital mortality in HF. The volumes of echocardiographic examinations were also associated with hospital mortality.
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- 2021
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20. Canagliflozin reduces epicardial fat in patients with type 2 diabetes mellitus
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Shusuke Yagi, Yukina Hirata, Takayuki Ise, Kenya Kusunose, Hirotsugu Yamada, Daiju Fukuda, Hotimah Masdan Salim, Gulinu Maimaituxun, Susumu Nishio, Yuriko Takagawa, Saori Hama, Tomomi Matsuura, Koji Yamaguchi, Takeshi Tobiume, Takeshi Soeki, Tetsuzo Wakatsuki, Ken-ichi Aihara, Masashi Akaike, Michio Shimabukuro, and Masataka Sata
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Epicardial adipose tissue ,SGLT2 inhibitors ,Echocardiography ,Nutritional diseases. Deficiency diseases ,RC620-627 - Abstract
Abstract Background It is unknown whether canagliflozin, a selective sodium glucose co-transporter 2 inhibitor, reduces epicardial adipose tissue (EAT) thickness, which is associated with insulin resistance and is a risk factor for coronary artery disease. Methods and results We administered 100 mg of canagliflozin for 6 months to 13 patients with type 2 diabetes mellitus. We evaluated glycemic control, visceral adipose tissue (VAT) area and subcutaneous adipose tissue (SAT) area, and skeletal muscle mass by using impedance methods, and EAT thickness by using echocardiography. Canagliflozin treatment for 6 months decreased hemoglobin A1c level from 7.1 ± 0.5% to 6.7 ± 0.6% (P
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- 2017
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21. Toll‐Like Receptor 9 Plays a Pivotal Role in Angiotensin II–Induced Atherosclerosis
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Daiju Fukuda, Sachiko Nishimoto, Kunduziayi Aini, Atsushi Tanaka, Tsuyoshi Nishiguchi, Joo‐ri Kim‐Kaneyama, Xiao‐Feng Lei, Kiyoshi Masuda, Takuya Naruto, Kimie Tanaka, Yasutomi Higashikuni, Yoichiro Hirata, Shusuke Yagi, Kenya Kusunose, Hirotsugu Yamada, Takeshi Soeki, Issei Imoto, Takashi Akasaka, Michio Shimabukuro, and Masataka Sata
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atherosclerosis ,inflammation ,macrophage ,Toll‐like receptor 9 ,vascular inflammation ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Toll‐like receptor (TLR) 9 recognizes bacterial DNA, activating innate immunity, whereas it also provokes inflammation in response to fragmented DNA released from mammalian cells. We investigated whether TLR9 contributes to the development of vascular inflammation and atherogenesis using apolipoprotein E–deficient (Apoe−/−) mice. Methods and Results Tlr9‐deficient Apoe−/− (Tlr9−/−Apoe−/−) mice and Apoe−/− mice on a Western‐type diet received subcutaneous angiotensin II infusion (1000 ng/kg per minute) for 28 days. Angiotensin II increased the plasma level of double‐stranded DNA, an endogenous ligand of TLR9, in these mice. Genetic deletion or pharmacologic blockade of TLR9 in angiotensin II–infused Apoe−/− mice attenuated atherogenesis in the aortic arch (P
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- 2019
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22. Association between Vitamin D and Heart Failure Mortality in 10,974 Hospitalized Individuals
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Kenya Kusunose, Yuichiro Okushi, Yoshihiro Okayama, Robert Zheng, Miho Abe, Michikazu Nakai, Yoko Sumita, Takayuki Ise, Takeshi Tobiume, Koji Yamaguchi, Shusuke Yagi, Daiju Fukuda, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, and Masataka Sata
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heart failure ,vitamin D ,mortality ,big data ,Nutrition. Foods and food supply ,TX341-641 - Abstract
A broad range of chronic conditions, including heart failure (HF), have been associated with vitamin D deficiency. Existing clinical trials involving vitamin D supplementation in chronic HF patients have been inconclusive. We sought to evaluate the outcomes of patients with vitamin D supplementation, compared with a matched cohort using real-world big data of HF hospitalization. This study was based on the Diagnosis Procedure Combination database in the Japanese Registry of All Cardiac and Vascular Datasets (JROAD-DPC). After exclusion criteria, we identified 93,692 patients who were first hospitalized with HF between April 2012 and March 2017 (mean age was 79 ± 12 years, and 52.2% were male). Propensity score (PS) was estimated with logistic regression model, with vitamin D supplementation as the dependent variable and clinically relevant covariates. On PS-matched analysis with 10,974 patients, patients with vitamin D supplementation had lower total in-hospital mortality (6.5 vs. 9.4%, odds ratio: 0.67, p < 0.001) and in-hospital mortality within 7 days and 30 days (0.9 vs. 2.5%, OR, 0.34, and 3.8 vs. 6.5%, OR: 0.56, both p < 0.001). In the sub-group analysis, mortalities in patients with age < 75, diabetes, dyslipidemia, atrial arrhythmia, cancer, renin-angiotensin system blocker, and β-blocker were not affected by vitamin D supplementation. Patients with vitamin D supplementation had a lower in-hospital mortality for HF than patients without vitamin D supplementation in the propensity matched cohort. The identification of specific clinical characteristics in patients benefitting from vitamin D may be useful for determining targets of future randomized control trials.
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- 2021
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23. Activation of Toll-Like Receptor 9 Impairs Blood Flow Recovery After Hind-Limb Ischemia
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Sachiko Nishimoto, Kunduziayi Aini, Daiju Fukuda, Yasutomi Higashikuni, Kimie Tanaka, Yoichiro Hirata, Shusuke Yagi, Kenya Kusunose, Hirotsugu Yamada, Takeshi Soeki, Michio Shimabukuro, and Masataka Sata
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hind-limb ischemia ,blood flow recovery ,Toll-like receptor 9 ,inflammation ,macrophage ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Peripheral artery disease causes significant functional disability and results in impaired quality of life. Ischemic tissue injury releases various endogenous ligands for Toll-like receptors (TLRs), suggesting the involvement of TLRs in blood flow recovery. However, the role of TLR9, which was originally known as a sensor for bacterial DNA, remains unknown. This study investigated the role of TLR9 in blood flow recovery in the ischemic limb using a mouse hind-limb ischemia model.Methods and Results: Unilateral femoral artery ligation was performed in TLR9-deficient (Tlr9−/−) mice and wild-type mice. In wild-type mice, femoral artery ligation significantly increased mRNA expression of TLR9 in the ischemic limb (P < 0.001) and plasma levels of cell-free DNA (cfDNA) as determined by single-stranded DNA (ssDNA) (P < 0.05) and double-stranded DNA (dsDNA) (P < 0.01), which are endogenous ligands for TLR9, compared with the sham-operated group. Laser Doppler perfusion imaging demonstrated significantly improved ratio of blood flow in the ischemic to non-ischemic limb in Tlr9−/− mice compared with wild-type mice at 2 weeks after ligation (P < 0.05). Tlr9−/− mice showed increased capillary density and reduced macrophage infiltration in ischemic limb. Genetic deletion of TLR9 reduced the expression of TNF-α, and attenuated NF-κB activation in ischemic muscle compared with wild-type mice (P < 0.05, respectively) at 3 days after the surgery. ODN1826, a synthetic agonistic oligonucleotide for TLR9, or plasma obtained from mice with ischemic muscle promoted the expression of TNF-α in wild-type macrophages (P < 0.05), but not in Tlr9−/− macrophages. ODN1826 also activated NF-κB signaling as determined by the degradation of IκBα in wild-type macrophages (P < 0.05), but not in Tlr9−/− macrophages. In vitro experiments using human umbilical vein endothelial cells demonstrated that TNF-α, or conditioned medium obtained from wild-type macrophages treated with ODN1826 accelerated cell death as determined by MTS assay (P < 0.05 and P < 0.01, respectively).Conclusion: Our results suggest that ischemic muscle releases cfDNA, which activates TLR9 and enhances inflammation, leading to impairment of blood flow recovery in the ischemic limb. cfDNA-TLR9 signaling may serve as a potential therapeutic target in ischemic limb disease.
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- 2018
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24. Predictive Factors for Efficacy of Dipeptidyl Peptidase-4 Inhibitors in Patients with Type 2 Diabetes Mellitus
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Shusuke Yagi, Ken-ichi Aihara, Masashi Akaike, Daiju Fukuda, Hotimah Masdan Salim, Masayoshi Ishida, Tomomi Matsuura, Takayuki Ise, Koji Yamaguchi, Takashi Iwase, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, Michio Shimabukuro, Toshio Matsumoto, and Masataka Sata
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Coronary artery disease ,Diabetes mellitus ,Dipeptidyl-peptidase IV inhibitors ,Obese ,Predictive factors ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
BackgroundPredictive factors for the efficacy of dipeptidyl peptidase-4 (DPP-4) inhibitors for lowering glycosylated hemoglobin (HbA1c) remain unclear in patients with type 2 diabetes mellitus. The aim of this study is therefore to clarify predictive factors of the efficacy of DPP-4 inhibitors for lowering HbA1c after 12 months of treatment.MethodsA total of 191 consecutive type 2 diabetic patients (male sex 55%, mean age, 68.3±35.8 years), who had been treated with DPP-4 inhibitors for 12 months, were enrolled in this study and evaluated retrospectively.ResultsAfter 12 months of DPP-4 inhibitor treatment, random blood glucose level, and HbA1c level, decreased from 167±63 to 151±49 mg/dL (P
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- 2015
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25. Plasma brain natriuretic peptide levels are elevated in patients with cancer.
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Sachiko Bando, Takeshi Soeki, Tomomi Matsuura, Takeshi Tobiume, Takayuki Ise, Kenya Kusunose, Koji Yamaguchi, Shusuke Yagi, Daiju Fukuda, Takashi Iwase, Hirotsugu Yamada, Tetsuzo Wakatsuki, Michio Shimabukuro, Naoki Muguruma, Tetsuji Takayama, Ichiro Kishimoto, Kenji Kangawa, and Masataka Sata
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Medicine ,Science - Abstract
Natriuretic peptides have been proposed as biomarkers of cardiovascular disease, especially heart failure. Brain natriuretic peptide (BNP) has also been shown to be upregulated at the transcriptional and translational levels by pro-inflammatory cytokines in cardiac myocytes. Although we often measure plasma BNP levels in cancer patients, it remains unknown whether cancer-related inflammation affects the plasma BNP levels. We investigated the relationship between the BNP and human cancers.We retrospectively studied 2,923 patients in whom the plasma BNP levels and serum C-reactive protein (CRP) were measured and echocardiography was performed. Patients with clinically evident heart failure (NYHA II or higher), heart disease requiring medical treatment or surgery, renal dysfunction, and inflammatory disease were excluded. There were 234 patients in the final analysis. Blood sampling was performed before surgery and chemotherapy. In addition, we evaluated the relationship between the inflammation and plasma BNP levels in mouse models of colon cancer.Of the 234 patients, 80 were diagnosed with cancer. Both the plasma BNP and serum CRP levels were significantly higher in cancer patients than those without. There were no significant differences in the echocardiographic parameters. There was a significant positive correlation between the plasma BNP and serum CRP levels in cancer patients (r = 0.360, P
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- 2017
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26. Gender-linked impact of epicardial adipose tissue volume in patients who underwent coronary artery bypass graft surgery or non-coronary valve surgery.
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Gulinu Maimaituxun, Michio Shimabukuro, Hotimah Masdan Salim, Minoru Tabata, Daisuke Yuji, Yoshihisa Morimoto, Takeshi Akasaka, Tomomi Matsuura, Shusuke Yagi, Daiju Fukuda, Hirotsugu Yamada, Takeshi Soeki, Takaki Sugimoto, Masashi Tanaka, Shuichiro Takanashi, and Masataka Sata
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Medicine ,Science - Abstract
Traditional and non-traditional risk factors for atherosclerotic cardiovascular disease (ASCVD) are different between men and women. Gender-linked impact of epicardial adipose tissue volume (EATV) in patients undergoing coronary artery bypass grafting (CABG) remains unknown.Gender-linked impact of EATV, abdominal fat distribution and other traditional ASCVD risk factors were compared in 172 patients (men: 115; women: 57) who underwent CABG or non-coronary valvular surgery (non-CABG).In men, EATV, EATV index (EATV/body surface area) and the markers of adiposity such as body mass index, waist circumference and visceral fat area were higher in the CABG group than in the non-CABG group. Traditional ASCVD risk factors were also prevalent in the CABG group. In women, EATV and EATV index were higher in the CABG group, but other adiposity markers were comparable between CABG and non-CABG groups. Multivariate logistic regression analysis showed that in men, CABG was determined by EATV Index and other ASCVD risk factors including hypertension, dyslipidemia, adiponectin, high sensitive C-reactive protein (hsCRP) and type 2 diabetes mellitus (Corrected R2 = 0.262, p < 0.0001), while in women, type 2 diabetes mellitus is a single strong predictor for CABG, excluding EATV Index (Corrected R2 = 0.266, p = 0.005).Our study found that multiple risk factors, including epicardial adipose tissue volume and traditional ASCVD factors are determinants for CABG in men, but type 2 diabetes mellitus was the sole determinant in women. Gender-specific disparities in risk factors of CABG prompt us to evaluate new diagnostic and treatment strategies and to seek underlying mechanisms.
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- 2017
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27. Glycemic control with ipragliflozin, a novel selective SGLT2 inhibitor, ameliorated endothelial dysfunction in streptozotocin-induced diabetic mouse
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Hotimah Masdan Salim, Daiju FUKUDA, Shusuke Yagi, Takeshi Soeki, Michio Shimabukuro, and Masataka Sata
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Hyperglycemia ,Inflammation ,Oxidative Stress ,Endothelial Function ,SGLT2 inhibitor ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Endothelial dysfunction caused by increased oxidative stress is a critical initiator of macro- and micro-vascular disease development in diabetic patients. Ipragliflozin, a selective sodium glucose co-transporter 2 (SGLT2) inhibitor, offers a novel approach for the treatment of diabetes by enhancing urinary glucose excretion. The aim of the present study was to examine whether ipragliflozin attenuates endothelial dysfunction in diabetic mice.Methods: Eight-week-old male C57BL/6 mice were treated with streptozotocin (150 mg/kg) by a single intraperitoneal injection to induce diabetes mellitus. At three days of injection, ipragliflozin (3 mg/kg/day) was administered via gavage for 3 weeks. Vascular function was assessed by isometric tension recording. Human umbilical endothelial cells (HUVEC) were used for in vitro experiments. RNA and protein expression were examined by quantitative RT-PCR (qPCR) and western blot, respectively. Oxidative stress was determined by measuring urine 8-hydroxy-2'-deoxyguanosine (8-OHdG) level.Results: Ipragliflozin administration significantly reduced blood glucose level (P
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- 2016
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28. MicroRNA-378 regulates adiponectin expression in adipose tissue: a new plausible mechanism.
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Masayoshi Ishida, Michio Shimabukuro, Shusuke Yagi, Sachiko Nishimoto, Chisayo Kozuka, Daiju Fukuda, Takeshi Soeki, Hiroaki Masuzaki, Masato Tsutsui, and Masataka Sata
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Medicine ,Science - Abstract
AIMS: Mechanisms regulating adiponectin expression have not been fully clarified. MicroRNAs (miRNAs), small non-coding RNAs that regulate gene expression, are involved in biological processes, including obesity and insulin resistance. We evaluated whether the miRNA-378 pathway is involved in regulating adiponectin expression. METHODS AND RESULTS: First, we determined a putative target site for miRNA-378 in the 3 prime untranslated region (3'UTR) of the adiponectin gene by in silico analysis. The levels of adiponectin mRNA and protein were decreased in 3T3-L1 cells overexpressing the mimic of miRNA-378. Luminescence activity in HEK293T cells expressing a renilla-luciferase-adiponectin-3'UTR sequence was inhibited by overexpressing the mimic of miRNA-378, and the decrease was reversed by adding the inhibitor of miRNA-378. Moreover, we confirmed the inhibitory effects of the mimic were cancelled in a deleted mutant of the miR-378 3'-UTR binding site. Addition of tumor necrosis factor-α (TNFα) led a upregulation of miR-378 and downregulation of adiponectin at mRNA and protein levels in 3T3-L1 cells. Level of miR-378 was higher and mRNA level of adiponectin was lower in diabetic ob/ob mice than those of normal C57BL/6 mice and levels of miR378 and adiponectin were negatively well correlated (r = -0.624, p = 0.004). CONCLUSIONS: We found that levels of miRNA-378 could modulate adiponectin expression via the 3'UTR sequence-binding site. Our findings warrant further investigations into the role of miRNAs in regulating the adiponectin expression.
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- 2014
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29. Response: Predictive Factors for Efficacy of Dipeptidyl Peptidase-4 Inhibitors in Patients with Type 2 Diabetes Mellitus ( 2015;39:342-7)
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Shusuke Yagi, Ken-ichi Aihara, and Masataka Sata
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Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Published
- 2015
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30. Effects of Statins on Cardiorenal Syndrome
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Shusuke Yagi, Ken-ichi Aihara, Yasumasa Ikeda, Masashi Akaike, Masataka Sata, and Toshio Matsumoto
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Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Cardiovascular disease and renal disease have a close relationship that forms a vicious cycle as a cardiorenal syndrome (CRS). Oxidative stress, endothelial dysfunction, and vascular inflammation could be therapeutic targets when the renin-angiotensin-aldosterone system is activated by accumulation of conventional cardiovascular risk factors; however, a strategy for management of CRS has not been established yet. Statins, HMG-CoA reductase inhibitors, have not only cholesterol-lowering effects but also pleiotropic effects on cardiovascular systems, including anti-inflammatory and antioxidant effects and improvement of nitric oxide bioavailability. Since recent studies have indicated that statins have beneficial effects on chronic kidney disease and heart failure as well as coronary artery disease in cholesterol-lowering-dependent/independent manners, treatment with statins might be a successful strategy for preventing deterioration of CRS.
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- 2012
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31. MicroRNA-22 regulates hypoxia signaling in colon cancer cells.
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Munekazu Yamakuchi, Shusuke Yagi, Takashi Ito, and Charles J Lowenstein
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Medicine ,Science - Abstract
MicroRNAs (MiRNAs) are short, non-coding RNA that regulate a variety of cellular functions by suppressing target protein expression. We hypothesized that a set of microRNA regulate tumor responses to hypoxia by inhibiting components of the hypoxia signaling pathway. We found that miR-22 expression in human colon cancer is lower than in normal colon tissue. We also found that miR-22 controls hypoxia inducible factor 1α (HIF-1α) expression in the HCT116 colon cancer cell line. Over-expression of miR-22 inhibits HIF-1α expression, repressing vascular endothelial growth factor (VEGF) production during hypoxia. Conversely, knockdown of endogenous miR-22 enhances hypoxia induced expression of HIF-1α and VEGF. The conditioned media from cells over-expressing miR-22 contain less VEGF protein than control cells, and also induce less endothelial cell growth and invasion, suggesting miR-22 in adjacent cells influences endothelial cell function. Taken together, our data suggest that miR-22 might have an anti-angiogenic effect in colon cancer.
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- 2011
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32. Usefulness of indocyanine green fluorescence-guided small intestinal bleeding site identification in small bowel resection: a report of two cases and literature review
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Kenta Aso, Shusuke Yagi, Kazuhiko Yamada, Daiki Kato, Naoki Enomoto, Kyoko Nohara, Dai Kitagawa, Nobuyuki Takemura, Tomomichi Kiyomatsu, and Norihiro Kokudo
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Gastroenterology ,General Medicine - Published
- 2023
33. A Selective Mineralocorticoid Receptor Blocker, Esaxerenone, Attenuates Vascular Dysfunction in Diabetic C57BL/6 Mice
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Uugantsetseg, Munkhjargal, Daiju, Fukuda, Byambasuren, Ganbaatar, Kumiko, Suto, Tomomi, Matsuura, Takayuki, Ise, Kenya, Kusunose, Koji, Yamaguchi, Shusuke, Yagi, Hirotsugu, Yamada, Takeshi, Soeki, Tetsuzo, Wakatsuki, and Masataka, Sata
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Biochemistry (medical) ,Internal Medicine ,Cardiology and Cardiovascular Medicine - Abstract
Pharmacological blockade of mineralocorticoid receptors (MRs) is a potential therapeutic approach to reduce cardiovascular complications since MRs play a crucial role in cardiovascular regulation. Recent studies suggest that MR antagonists affect several extrarenal tissues, including vessel function. We investigated the effect of a novel nonsteroidal selective MR blocker, esaxerenone, on diabetes-induced vascular dysfunction.Diabetes was induced by a single dose of streptozotocin in 8-week-old male C57BL/6 mice. Esaxerenone (3 mg/kg/day) or a vehicle was administered by gavage to diabetic mice for 3 weeks. Metabolic parameters, plasma aldosterone levels, and parameters related to renal function were measured. Endothelium-dependent or -independent vascular responses of the aortic segments were analyzed with acetylcholine or sodium nitroprusside, respectively. Human umbilical vein endothelial cells (HUVECs) were used for the in vitro study.Induction of diabetes elevated plasma aldosterone level (P<0.05) and impaired endothelium-dependent vascular relaxation (P<0.05). The administration of esaxerenone ameliorated the endothelial dysfunction (P<0.01) without the alteration of metabolic parameters, blood pressure, and renal function. Esaxerenone improved the eNOSEsaxerenone attenuates the development of diabetes-induced endothelial dysfunction in mice. These results suggest that esaxerenone has potential vascular protective effects in individuals with diabetes.
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- 2023
34. Gastric cancer with a giant lymph node metastasis: a case report and review of the literature
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Chihiro Matsumoto, Naoki Enomoto, Kazuhiko Yamada, Daiki Kato, Shusuke Yagi, Kyoko Nohara, Norihiro Kokudo, Kento Misumi, and Toru Igari
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Gastroenterology ,General Medicine - Published
- 2023
35. New quantitative indices of cardiac amyloidosis with 99mTc-pyrophosphate scintigraphy
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Noritake Matsuda, Hideki Otsuka, Tamaki Otani, Shota Azane, Yamato Kunikane, Yoichi Otomi, Yuya Ueki, Masahiro Kubota, Masafumi Amano, Shusuke Yagi, Masataka Sata, and Masafumi Harada
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Total amyloid uptake (TAU) ,Becquerel calibration factor (BCF) ,Cardiac amyloidosis (CA) ,Radiology, Nuclear Medicine and imaging ,Amyloid deposition volume (AmyDV) ,Standardized uptake value (SUV) - Abstract
Purpose: Amyloid light chain (AL) and transthyretin (ATTR) are the major subtypes of cardiac amyloidosis (CA). 99mTc-pyrophosphate (PYP) scintigraphy is used to differentiate ATTR from other CA subtypes. We adapted the standardized uptake value (SUV) for 99mTc-PYP and proposed two quantitative indices, amyloid deposition volume (AmyDV) and total amyloid uptake (TAU). This study aimed to evaluate the utility of these quantitative indices in differentiating ATTR from non-ATTRs. Materials and methods: Before the SUV measurement, the Becquerel calibration factor (BCF) of 99mTc was obtained by a phantom experiment. Thirty-two patients who had undergone hybrid SPECT/CT imaging 3 h after injection of 99mTc-PYP (370 MBq) were studied. CT attenuation correction for image reconstruction was applied in all. We calculated SUV, AmyDV, and TAU using a quantitative analysis software program for bone SPECT (GI-BONE) and analyzed AmyDV using two methods: Threshold method (set 40%); and constant value method (average SUVmax of ribs). We assessed the diagnostic ability of heart-to-contralateral lung (H/CL) ratio, SUV, AmyDV, and TAU to differentiate ATTR from non-ATTR using receiver operating characteristic (ROC) analysis. Results: Statistically significant differences in all quantitative indices were observed between ATTR and non-ATTR. The area under the curve of each quantitative index for discriminating between ATTR and non-ATTR were as follows: H/CL, 0.997; SUVmax, 0.953; SUVmean (M1), 0.964; SUVmean (M2), 0.969; AmyDV (M1), 0.875; AmyDV (M2), 0.974; and TAU, 0.974. The AmyDV (M2) had higher diagnostic ability than AmyDV (M1). Thus, TAU was calculated as AmyDV (M2) × SUVmean (M2). In the ROC curve, SUV, AmyDV, and TAU had almost the same diagnostic ability as H/CL in distinguishing ATTR from non-ATTRs. Conclusions: We propose two novel 3D-based quantitative parameters (AmyDV and TAU) that have almost equal ability to discriminate ATTR from non-ATTR.
- Published
- 2022
36. Isoproterenol loading transesophageal echocardiography in atrial fibrillation
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Tomonori, Takahashi, Kenya, Kusunose, Shuji, Hayashi, Robert, Zheng, Natsumi, Yamaguchi, Sae, Morita, Yukina, Hirata, Susumu, Nishio, Yoshihito, Saijo, Takayuki, Ise, Koji, Yamaguchi, Shusuke, Yagi, Hirotsugu, Yamada, Takeshi, Soeki, Tetsuzo, Wakatsuki, and Masataka, Sata
- Abstract
In patients with sludge or severe spontaneous echo contrast (SEC) in the left atrial appendage (LAA), cases with isoproterenol loading transesophageal echocardiography (ISP-TEE) have been reported to identify the presence of thrombus in the LAA. This study aimed to assess the validity and hemodynamic changes of ISP-TEE in the LAA. We prospectively enrolled patients with atrial fibrillation (AF) who underwent ISP-TEE. The degree of sludge/SEC was categorized as being either absent (grade 0), mild SEC (grade 1), moderate SEC (grade 2), severe SEC or sludge (grade 3). The hemodynamic evaluation was performed by measuring LAA flow velocity, LAA tissue Doppler imaging (LAA-TDI) velocity, and pulmonary vein systolic forward flow velocity (PVS). In total, 35 patients (mean age 71 ± 7 years; 71% male) underwent ISP-TEE. Among 35 patients, 30 patients had grade 3 or 2 SEC, 5 patients had grade 1 SEC. After ISP loading, 23 patients (66% of all patients) showed improved sludge/SEC and one patient was diagnosed with thrombus in the LAA. There were 25 patients with grade 1 SEC, or no SEC (classified as Group1), 10 patients had residual sludge or grade 2 to 3 SEC (classified as Group2) after ISP administration. LAA flow, LAA-TDI, and PVS velocities were significantly higher in group 1 than in group 2 after ISP administration. There was no complication during the examination and after 24 h and 3 months. ISP infusion may be a potential tool to recognize LAA thrombus under the sludge/SEC during TEE in AF.
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- 2022
37. Effect of ipragliflozin on carotid intima-media thickness in type 2 diabetes patients
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Atsushi, Tanaka, Masataka, Sata, Yosuke, Okada, Hiroki, Teragawa, Kazuo, Eguchi, Michio, Shimabukuro, Isao, Taguchi, Kazuo, Matsunaga, Yumiko, Kanzaki, Hisako, Yoshida, Tomoko, Ishizu, Shinichiro, Ueda, Masafumi, Kitakaze, Toyoaki, Murohara, Koichi, Node, Yoshihiko, Nishio, Mitsuru, Ohishi, Kazuomi, Kario, Wataru, Shimizu, Hideaki, Jinnouchi, Hirofumi, Tomiyama, Koji, Maemura, Makoto, Suzuki, Shinichi, Ando, Haruo, Kamiya, Tomohiro, Sakamoto, Mamoru, Nanasato, Munehide, Matsuhisa, Junya, Ako, Yoshimasa, Aso, Masaharu, Ishihara, Kazuo, Kitagawa, Akira, Yamashina, Yumi, Ikehara, Ayako, Takamori, Miki, Mori, Kaori, Yamaguchi, Machiko, Asaka, Tetsuya, Kaneko, Masashi, Sakuma, Shigeru, Toyoda, Takahisa, Nasuno, Michiya, Kageyama, Jojima, Teruo, Iijima, Toshie, Haruka, Kishi, Hirotsugu, Yamada, Kenya, Kusunose, Daiju, Fukuda, Shusuke, Yagi, Koji, Yamaguchi, Takayuki, Ise, Yutaka, Kawabata, Akio, Kuroda, Yuichi, Akasaki, Mihoko, Kurano, Satoshi, Hoshide, Takahiro, Komori, Tomoyuki, Kabutoya, Yukiyo, Ogata, Yuji, Koide, Hiroaki, Kawano, Satoshi, Ikeda, Satoki, Fukae, Seiji, Koga, Yukihito, Higashi, Shinji, Kishimoto, Masato, Kajikawa, Tatsuya, Maruhashi, Yoshiaki, Kubota, Yoshisato, Shibata, Nehiro, Kuriyama, Ikuko, Nakamura, Kanemitsu, Hironori, Bonpei, Takase, Yuichi, Orita, Chikage, Oshita, Yuko, Uchimura, Ruka, Yoshida, Yukihiko, Yoshida, Hirohiko, Suzuki, Yasuhiro, Ogura, Mayuho, Maeda, Masaki, Takenaka, Takumi, Hayashi, Mirai, Hirose, Itaru, Hisauchi, Toshiaki, Kadokami, Ryo, Nakamura, Junji, Kanda, Masaaki, Hoshiga, Koichi, Sohmiya, Arihiro, Koyosue, Hiroki, Uehara, Naoto, Miyagi, Toshiya, Chinen, Kentaro, Nakamura, Chikashi, Nago, Suguru, Chiba, Sho, Hatano, Yoshikatsu, Gima, Masami, Abe, Masayoshi, Ajioka, Hiroshi, Asano, Yoshihiro, Nakashima, Hiroyuki, Osanai, Takahiro, Kanbara, Yusuke, Sakamoto, Mitsutoshi, Oguri, Shiou, Ohguchi, Kunihiko, Takahara, Kazuhiro, Izumi, Kenichiro, Yasuda, Akihiro, Kudo, Noritaka, Machii, Ryota, Morimoto, Yasuko, Bando, Takahiro, Okumura, Toru, Kondo, Shin-Ichiro, Miura, Yuhei, Shiga, Joji, Mirii, Makoto, Sugihara, Tadaaki, Arimura, Junko, Nakano, Kazuhisa, Kodama, Nobuyuki, Ohte, Tomonori, Sugiura, Kazuaki, Wakami, Yasuhiko, Takemoto, Minoru, Yoshiyama, Taichi, Shuto, Kazuo, Fukumoto, Kenichi, Tanaka, Satomi, Sonoda, Akemi, Tokutsu, Takashi, Otsuka, Fumi, Uemura, Kenji, Koikawa, Megumi, Miyazaki, Maiko, Umikawa, Manabu, Narisawa, Machi, Furuta, Hiroshi, Minami, Masaru, Doi, Kazuhiro, Sugimoto, Susumu, Suzuki, Akira, Kurozumi, and Kosuke, Nishio
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Ipragliflozin ,Type 2 diabetes ,Pharmacology (medical) ,Carotid intima-media thickness ,Atherosclerosis ,Cardiology and Cardiovascular Medicine - Abstract
Aims To examine the effects of a 24-month treatment with ipragliflozin on carotid intima-media thickness (IMT) in type 2 diabetes patients. Methods and results In this multicenter, prospective, randomized, open-label, and blinded-endpoint investigator-initiated clinical trial, adults with type 2 diabetes and haemoglobin A1C (HbA1c) of 6.0–10.0% (42–86 mmol/mol) were randomized equally to ipragliflozin (50 mg daily) and non-sodium-glucose cotransporter-2 (SGLT2) inhibitor use of standard-care (control group) for type 2 diabetes and were followed-up to 24 months. The primary endpoint was the change in mean common carotid artery IMT (CCA-IMT) from baseline to 24 months. A total of 482 patients were equally allocated to the ipragliflozin (N = 241) and control (N = 241) groups, and 464 patients (median age 68 years, female 31.7%, median type 2 diabetes duration 8 years, median HbA1c 7.3%) were included in the analyses. For the primary endpoint, the changes in the mean CCA-IMT from baseline to 24 months were 0.0013 [95% confidence interval (CI), −0.0155–0.0182] mm and 0.0015 (95% CI, −0.0155–0.0184) mm in the ipragliflozin and control groups, respectively, with an estimated group difference (ipragliflozin-control) of −0.0001 mm (95% CI, −0.0191–0.0189; P = 0.989). A group difference in HbA1c change at 24 months was also non-significant between the treatment groups [−0.1% (95% CI, −0.2–0.1); P = 0.359]. Conclusion Twenty-four months of ipragliflozin treatment did not affect carotid IMT status in patients with type 2 diabetes recruited in the PROTECT study, relative to the non-SGLT2 inhibitor-use standard care for type 2 diabetes.
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- 2022
38. Clinical outcomes of palliative treatment for gastric bleeding from incurable gastric cancer
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Shusuke, Yagi, Satoshi, Ida, Ken, Namikawa, Masaru, Hayami, Rie, Makuuchi, Koshi, Kumagai, Manabu, Ohashi, Takeshi, Sano, and Souya, Nunobe
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Surgery ,General Medicine - Abstract
Deciding palliative treatment for gastric bleeding from incurable gastric cancer (IGC) is worrying considering different patient situations and the lack of comprehensive assessment of palliative treatment. We evaluated the clinical outcomes and prognostic factors after palliative treatment for gastric bleeding from IGC.We enrolled 48 consecutive patients with gastric bleeding from IGC who underwent palliative surgery (PS) or palliative radiotherapy (PRT).Of the 48 patients, 23 underwent PS and 25 received PRT. More patients who had an Eastern Cooperative Oncology Group-Performance Status (ECOG-PS) ≥ 2 or who received chemotherapy underwent PRT than underwent PS. Severe complications were observed in 2 (8.6%) patients after PS. After PRT, 22 patients achieved hemostasis (88%), but rebleeding was found in 10 (40%). Chemotherapy was introduced after palliative treatment for 21 (91.3%) patients in the PS group and 17 (68%) patients in the PRT group. The median survival time (MST) of patients with and without chemotherapy after PS was 12.5 and 3.1 months, respectively (p ≤ 0.001), while the MST of patients with and without chemotherapy after PRT was 6.5 and 1.6 months (p 0.001). Multivariate analyses identified ECOG-PS, tumor size, and chemotherapy after palliative treatment as independent risk factors.Palliative treatment strategies for gastric bleeding should be determined with consideration of the general condition, previous chemotherapy, and chemotherapy after palliative treatment.
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- 2022
39. Regression of left ventricular hypertrophy after tafamidis therapy in a patient with transthyretin amyloidosis variant
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Shusuke Yagi, Hiromu Yamazaki, Kenya Kusunose, Yusuke Osaki, Takayuki Ise, Muneyuki Kadota, Munkhtsetseg Tserensonom, Yutaka Kawabata, Tomoya Hara, Rie Ueno, Yoshihito Saijo, Tomomi Matsuura, Koji Yamaguchi, Hirotsugu Yamada, Daiju Fukuda, Takeshi Soeki, Tetsuzo Wakatsuki, and Masataka Sata
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Amyloid Neuropathies, Familial ,Benzoxazoles ,Humans ,Prealbumin ,Hypertrophy, Left Ventricular ,General Medicine ,hereditary amyloidosis ,cardiomyopathy ,General Biochemistry, Genetics and Molecular Biology ,hypertrophic hepertrophy - Abstract
Transthyretin amyloidosis (ATTR) variant is a life-threatening hereditary disease predominantly affecting the peripheral nervous system and heart. Tafamidis, which prevents the deposition of amyloid by stabilizing transthyretin, is available for the treatment of neuropathy and cardiomyopathy of ATTR. However, whether tafamidis could eliminate established amyloid deposits and improve cardiac function remains unknown. We reported a case of regression of left ventricular hypertrophy after tafamidis therapy in a patient with an ATTR variant. J. Med. Invest. 69 : 320-322, August, 2022.
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- 2022
40. Effects of Radiofrequency Catheter Ablation on Cardiac Reserve Using Preload Stress Echocardiography in Paroxysmal and Persistent Atrial Fibrillation
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Nao Ishii, Kenya Kusunose, Ayu Shono, Kensuke Matsumoto, Susumu Nishio, Natsumi Yamaguchi, Yukina Hirata, Tomomi Matsuura, Takayuki Ise, Koji Yamaguchi, Shusuke Yagi, Daiju Fukuda, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, and Masataka Sata
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Male ,Middle Aged ,Risk Assessment ,Treatment Outcome ,Predictive Value of Tests ,Risk Factors ,Atrial Fibrillation ,Catheter Ablation ,Quality of Life ,Humans ,Female ,Cardiology and Cardiovascular Medicine ,Aged ,Echocardiography, Stress - Abstract
The effects of catheter ablation on exercise tolerance and quality of life in patients with atrial fibrillation (AF) have been reported. We assessed cardiac function in more detail using the leg positive pressure (LPP) technique and found that contractile reserve is particularly important in relation to exercise tolerance and prognosis. In this study, we used the LPP technique to examine changes in contractile reserve immediately after ablation and 6 months later. We prospectively enrolled patients who underwent catheter ablation for AF at 2 institutes. We performed LPP stress echocardiography 2 to 3 days after (FU-1) and 6 months after (FU-2) ablation to examine changes in cardiac function indexes. The primary end point was improvement in contractile reserve. Ultimately, 109 patients (mean age 67.4 ± 9.6 years; 70% men) underwent 2 sessions of LPP stress echocardiography. The median CHA
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- 2022
41. Preload Stress Echocardiography for the Assessment of Heart Failure With Preserved Ejection Fraction
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Yoshihito Saijo, Hirotsugu Yamada, Takayuki Ise, Tetsuzo Wakatsuki, Koji Yamaguchi, Takeshi Soeki, Kenya Kusunose, Daiju Fukuda, Susumu Nishio, Shusuke Yagi, Yukina Hirata, and Masataka Sata
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Heart Failure ,medicine.medical_specialty ,business.industry ,Stroke Volume ,Ventricular Function, Left ,Preload ,Predictive Value of Tests ,Internal medicine ,Cardiology ,medicine ,Stress Echocardiography ,Humans ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Heart failure with preserved ejection fraction ,Echocardiography, Stress - Published
- 2022
42. JCS/JACR 2021 Guideline on Rehabilitation in Patients With Cardiovascular Disease
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Shigeru, Makita, Takanori, Yasu, Yoshihiro J, Akashi, Hitoshi, Adachi, Hideo, Izawa, Shunichi, Ishihara, Yoshitaka, Iso, Hideo, Ohuchi, Kazuto, Omiya, Yusuke, Ohya, Koichi, Okita, Yutaka, Kimura, Akira, Koike, Masahiro, Kohzuki, Shinji, Koba, Masataka, Sata, Kazunori, Shimada, Tomoki, Shimokawa, Hirokazu, Shiraishi, Naokata, Sumitomo, Tetsuya, Takahashi, Tomoyuki, Takura, Hiroyuki, Tsutsui, Masatoshi, Nagayama, Emiko, Hasegawa, Yoshihiro, Fukumoto, Yutaka, Furukawa, Shin-Ichiro, Miura, Satoshi, Yasuda, Sumio, Yamada, Yuichiro, Yamada, Dai, Yumino, Toshiko, Yoshida, Takuji, Adachi, Toshimi, Ikegame, Kazuhiro P, Izawa, Takeshi, Ishida, Neiko, Ozasa, Naohiko, Osada, Hiroaki, Obata, Naoya, Kakutani, Yusuke, Kasahara, Masaaki, Kato, Kentaro, Kamiya, Shintaro, Kinugawa, Yuji, Kono, Yasuyuki, Kobayashi, Teruyuki, Koyama, Kazuhiro, Sase, Shinji, Sato, Tatsuhiro, Shibata, Norio, Suzuki, Daisuke, Tamaki, Minako, Yamaoka-Tojo, Michio, Nakanishi, Eisaku, Nakane, Mari, Nishizaki, Taiki, Higo, Kanta, Fujimi, Tasuku, Honda, Yasuharu, Matsumoto, Noriko, Matsumoto, Ikuko, Miyawaki, Makoto, Murata, Shusuke, Yagi, Masanobu, Yanase, Midori, Yamada, Miho, Yokoyama, Noboru, Watanabe, Haruki, Ito, Takeshi, Kimura, Syunei, Kyo, Yoichi, Goto, Ryuji, Nohara, and Ken-Ichi, Hirata
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- 2022
43. Infective Endocarditis from Furuncle with Meningitis Complication Caused by Methicillin-resistant Staphylococcus aureus
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Mariko Niki, Momoyo Azuma, Keiji Murakami, Akihiro Tani, Hirotsugu Yamada, Daiju Fukuda, Shusuke Yagi, Takayuki Ise, Takeshi Tobiume, Yutaka Kawabata, Takeshi Soeki, Ryosuke Miyamoto, Hiroki Hata, Mikio Sugano, Tetsuzo Wakatsuki, Kenya Kusunose, Koji Yamaguchi, Masataka Sata, Tomomi Matsuura, Muneyuki Kadota, and Tomoko Takahashi
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business.industry ,Leukocidin ,General Medicine ,biochemical phenomena, metabolism, and nutrition ,030204 cardiovascular system & hematology ,Skin infection ,bacterial infections and mycoses ,medicine.disease ,medicine.disease_cause ,Pathogenicity ,Methicillin-resistant Staphylococcus aureus ,Microbiology ,03 medical and health sciences ,0302 clinical medicine ,Staphylococcus aureus ,Infective endocarditis ,Internal Medicine ,medicine ,030211 gastroenterology & hepatology ,skin and connective tissue diseases ,Complication ,business ,Meningitis - Abstract
Infective endocarditis (IE) may be acquired in the community as community-acquired (CA) IE or in the healthcare setting. In Japan, cases of CA-methicillin-resistant Staphylococcus aureus (MRSA) infection as skin infection have been increasing. CA-MRSA strains, including the USA300 clone, have higher pathogenicity and are more destructive to tissue than healthcare-associated MRSA strains because of the toxins they produce, including arginine-catabolic mobile element (ACME) and Panton-Valentine leukocidin (PVL). However, only a few IE cases induced by USA300 have been reported. We herein report a 64-year-old man who developed CA-IE from a furuncle caused by USA300 MRSA producing PVL and ACME, which resulted in complications of meningitis.
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- 2021
44. 542. A CASE REPORT OF METACHRONOUS CERVICAL ESOPHAGEAL CANCER 7 YEARS AFTER ESOPHAGECTOMY WITH MULTIDISCIPLINARY TREATMENT
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Daiki Kato, Kazuhiko Yamada, Kyoko Nohara, Naoki Enomoto, Shusuke Yagi, Yuto Suyama, Kenta Aso, Naoki Akazawa, Chizu Yokoi, and Norihiro Kokudo
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Gastroenterology ,General Medicine - Abstract
Background: It is important to check for secondary cancer after esophagectomy. Especially, radiation or chemotherapy for recurrent esophageal cancer, were often performed, and it may be difficult to select treatment for metachronous cancer. We report a case of surgical resection for metachronous cervical esophageal cancer after 7 years for thoracic esophageal cancer with multidisciplinary treatment. Method: A 73-year-old woman underwent right thoracotomy and intrathoracic anastomosis before preoperative chemotherapy for lower thoracic esophageal cancer cT3N3M1 (LN104R) 7 years ago. Final pathological finding was UICC-pT3N3M1 and postoperative additional irradiation was performed. Fifteen months after surgery, there was recurrence of LN112AoP, and definitive chemoradiation therapy was performed. The lesion maintained complete response. Seven years later, upper gastrointestinal endoscopy revealed residual cervical esophageal cancer, and the diagnosis was cT1b (SM) N0M0. Result: Since re-CRT was difficult because of history of irradiation and CRT, we selected surgical cervical esophagectomy without thoracotomy. After partial excision of sternum to widen the view of the upper mediastinum, bilateral laryngeal recurrent nerves were preserved, and trachea and cervical esophagus were exposed. We resected cervical esophagectomy and reconstructed by pedicled jejunum with microvascular anastomosis. The stump of gastric conduit in the thoracic cavity was closed. The final pathology was UICC-pT1bN0M0. Conclusion: There are some cases in which long-term survival can be obtained even for advanced esophageal cancer. It is important to check for secondary cancer after esophagectomy. Radiation therapy and chemotherapy are often used for recurrence of esophageal cancer. We experienced surgical resection for metachronous cervical esophageal cancer 7 years after multidisciplinary treatment for esophageal cancer.
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- 2022
45. 546. THE IMPACT OF PREOPERATIVE DENTITION ON POSTOPERATIVE SPUTUM SURVEILLANCE CULTURE AND POSTOPERATIVE PNEUMONIA IN PATIENTS WITH ESOPHAGEAL CANCER
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Naoki Enomoto, Kazuhiko Yamada, Daiki Kato, Shusuke Yagi, Kyoko Nohara, and Norihiro Kokudo
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Gastroenterology ,General Medicine - Abstract
Preoperative dental cleaning and treatment are increasingly performed as part of perioperative management, and postoperative pneumonia has been reported to be reduced by these dental interventions in patients with esophageal cancer. However, few studies have surveyed the impact of dentition on postoperative sputum culture and pneumonia. Fifty-five consecutive patients who underwent subtotal esophagectomy at Center Hospital of the National Center for Global Health and Medicine between November 2015 and August 2020 were included. Salvage cases, two-stage procedures, and cases with inadequate dental findings were excluded. The number of lost teeth was investigated, and the relationship between sputum surveillance cultures collected on the first to fourth day after surgery and the development of postoperative pneumonia was analyzed. Postoperative sputum surveillance culture revealed pathogenic organisms in 31 (56%) patients. Candida species/P. aeruginosa/Klebsiella species/E. cloacae/S. maltophilia/S. pneumoniae/S. aureus were detected in 27/13/9/7/5/4/4/4%, respectively. Pathogenic organisms were detected significantly more frequently in cases with more than ten lost teeth (p Twelve patients (22%) had postoperative pneumonia with Clavien-Dindo grade 2 or higher. Postoperative pneumonia occurred significantly more frequently in patients with more than ten lost teeth (p=0.03, odds ratio 4.62, 95% CI 1.20-17.8). Postoperative pneumonia occurred significantly more frequently in patients in whom pathogens were detected (p=0.046, odds ratio 5.75, 95% CI 1.12-29.4). Patients with many lost teeth tended to have pathogens detected in early postoperative surveillance cultures before the onset of pneumonia and have more risk of developing postoperative pneumonia.
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- 2022
46. Activated Factor X Signaling Pathway via Protease-Activated Receptor 2 Is a Novel Therapeutic Target for Preventing Atrial Fibrillation
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Tomomi Matsuura, Takeshi Tobiume, Etsuko Uematsu, Tomoya Hara, Takayuki Ise, Shusuke Yagi, Tetsuzo Wakatsuki, Takeshi Soeki, Koji Yamaguchi, Daiju Fukuda, Kenya Kusunose, Masataka Sata, and Hirotsugu Yamada
- Subjects
0301 basic medicine ,Inflammation ,030204 cardiovascular system & hematology ,Pharmacology ,Mice ,03 medical and health sciences ,0302 clinical medicine ,Rivaroxaban ,Atrial Fibrillation ,medicine ,Animals ,Receptor, PAR-2 ,cardiovascular diseases ,Atrium (heart) ,Receptor ,Protease-activated receptor 2 ,business.industry ,Angiotensin II ,Warfarin ,Atrial fibrillation ,General Medicine ,medicine.disease ,Rats ,030104 developmental biology ,medicine.anatomical_structure ,Factor Xa ,cardiovascular system ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Signal Transduction ,medicine.drug - Abstract
Background Activated factor X (FXa), which contributes to chronic inflammation via protease-activated receptor 2 (PAR2), might play an important role in atrial fibrillation (AF) arrhythmogenesis. This study aimed to assess whether PAR2 signaling contributes to AF arrhythmogenesis and whether rivaroxaban ameliorates atrial inflammation and prevents AF.Methods and Results:In Study 1, PAR2 deficient (PAR2-/-) and wild-type mice were infused with angiotensin II (Ang II) or a vehicle via an osmotic minipump for 2 weeks. In Study 2, spontaneously hypertensive rats (SHRs) were treated with rivaroxaban, warfarin, or vehicle for 2 weeks after 8 h of right atrial rapid pacing. The AF inducibility and atrial remodeling in both studies were examined. Ang II-treated PAR2-/- mice had a lower incidence of AF and less mRNA expression of collagen1 and collagen3 in the atrium compared to wild-type mice treated with Ang II. Rivaroxaban significantly reduced AF inducibility compared with warfarin or vehicle. In SHRs treated with a vehicle, rapid atrial pacing promoted gene expression of inflammatory and fibrosis-related biomarkers in the atrium. Rivaroxaban, but not warfarin, significantly reduced expression levels of these genes. Conclusions The FXa-PAR2 signaling pathway might contribute to AF arrhythmogenesis associated with atrial inflammation. A direct FXa inhibitor, rivaroxaban, could prevent atrial inflammation and reduce AF inducibility, probably by inhibiting the pro-inflammatory activation.
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- 2021
47. An Adult Case of Congenital Extrahepatic Portosystemic Shunt Successfully Treated with Balloon-occluded Retrograde Transvenous Obliteration
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Takahiro Tanaka, Yoshihito Saijo, Shusuke Yagi, Masahiro Sogabe, Yasushi Sato, Tetsu Tomonari, Hironori Tanaka, Masataka Sata, Tatsuya Taniguchi, Naoki Muguruma, Koichi Tsuneyama, Koichi Okamoto, Hiroshi Miyamoto, and Tetsuji Takayama
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Adult ,medicine.medical_specialty ,Liver tumor ,Case Report ,030204 cardiovascular system & hematology ,Esophageal and Gastric Varices ,03 medical and health sciences ,0302 clinical medicine ,FNH-like nodule ,Internal Medicine ,medicine ,Humans ,Portopulmonary hypertension ,congenital extrahepatic portosystemic shunt ,medicine.diagnostic_test ,Portal Vein ,business.industry ,Liver Neoplasms ,Focal nodular hyperplasia ,General Medicine ,Balloon Occlusion ,medicine.disease ,Pulmonary hypertension ,Hypoplasia ,Shunt (medical) ,Treatment Outcome ,Hepatic Encephalopathy ,Liver biopsy ,portopulmonary hypertension ,Female ,030211 gastroenterology & hepatology ,Radiology ,Portasystemic Shunt, Transjugular Intrahepatic ,Portosystemic shunt ,B-RTO ,business - Abstract
A 42-year-old woman visited our hospital due to syncope. Contrast-enhanced CT revealed portosystemic shunt, portal vein hypoplasia, and multiple liver nodules. The histological examination of a liver biopsy specimen exhibited portal vein hypoplasia and revealed that the liver tumor was positive for glutamine synthetase. The patient was therefore diagnosed with congenital extrahepatic portosystemic shunt type II, and with focal nodular hyperplasia (FNH)-like nodules. She had the complication of severe portopulmonary hypertension and underwent complete shunt closure by balloon-occluded retrograde transvenous obliteration (B-RTO). The intrahepatic portal vein was well developed at 1 year after B-RTO, and multiple liver nodules completely regressed. Her pulmonary hypertension also improved.
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- 2021
48. Lipoprotein (a) is a risk factor of aortic valve calcification in patients with a risk of atherosclerosis.
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Tserensonom, Munkhtsetseg, Shusuke Yagi, Takayuki Ise, Yutaka Kawabata, Muneyuki Kadota, Tomoya Hara, Kenya Kusunose, Koji Yamaguchi, Hirotsugu Yamada, Takeshi Soeki, Tetsuzo Wakatsuki, and Masataka Sata
- Subjects
LIPOPROTEINS ,AORTIC valve ,CALCIFICATION ,AORTIC stenosis ,CORONARY angiography - Abstract
Aortic valve calcification (AVC), which causes aortic stenosis (AS), is more common in elderly persons. Controlling for conventional risk variables did not, however, reduce the incidence of AS. Thus, residual risk factors of AS should be identified. We enrolled 513 patients who underwent coronary angiography with computed tomography because of suspicion of coronary artery disease (CAD) or ruling out of CAD before aortic valve replacement. Calcium volume was calculated with a commercially available application. Conventional and lipid-related risk factors including serum levels of Lp(a) were evaluated for all patients. Calcium volume and Lp(a) levels were significantly higher in patients who underwent aortic valve replacement than in those who did not. A single regression analysis showed that the calcium volume was positively associated with age and the Lp(a) levels and negatively associated with the estimated glomerular filtration rate. No statistical significance was observed for other risk factors, including oxidized low-density lipoprotein, omega-3 fatty acids levels. The multiple regression analysis revealed that age (P < 0.001), female sex (P < 0.05), Lp(a) (P < 0.01), and hemoglobin A1c (P < 0.01) were determinants of the calcium volume. The area under the curve in receiver operating characteristic analysis of Lp(a) for implementation of AVR was 0.65 at an Lp(a) cut-off level of 16 mg/dL. In conclusion, the serum Lp(a) level is a potent risk factor of AVC in patients with high risk of atherosclerosis. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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49. Pemafibrate, A Novel Selective Peroxisome Proliferator-Activated Receptor α Modulator, Reduces Plasma Eicosanoid Levels and Ameliorates Endothelial Dysfunction in Diabetic Mice
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Hirotsugu Yamada, Takeshi Soeki, Shusuke Yagi, Kumiko Suto, Masataka Sata, Daiju Fukuda, Kenya Kusunose, Byambasuren Ganbaatar, Masakazu Shinohara, and Ken-ichi Hirata
- Subjects
medicine.medical_specialty ,Vasodilator Agents ,Peroxisome proliferator-activated receptor ,030204 cardiovascular system & hematology ,03 medical and health sciences ,chemistry.chemical_compound ,Mice ,0302 clinical medicine ,Diabetes mellitus ,Internal medicine ,Internal Medicine ,medicine ,Animals ,PPAR alpha ,Endothelial dysfunction ,Triglycerides ,Hypolipidemic Agents ,chemistry.chemical_classification ,Benzoxazoles ,Triglyceride ,Biochemistry (medical) ,Diabetes ,Endothelial function ,Eicosanoid ,medicine.disease ,Streptozotocin ,Thromboxane B2 ,Lipoproteins, LDL ,Vasodilation ,Butyrates ,Endocrinology ,Pemafibrate ,chemistry ,Vasoconstriction ,Eicosanoids ,Arachidonic acid ,Original Article ,Endothelium, Vascular ,Drug Monitoring ,Cardiology and Cardiovascular Medicine ,030217 neurology & neurosurgery ,Diabetic Angiopathies ,medicine.drug - Abstract
Aims: Various pathological processes related to diabetes cause endothelial dysfunction. Eicosanoids derived from arachidonic acid (AA) have roles in vascular regulation. Fibrates have recently been shown to attenuate vascular complications in diabetics. Here we examined the effects of pemafibrate, a selective peroxisome proliferator-activated receptor α modulator, on plasma eicosanoid levels and endothelial function in diabetic mice. Methods: Diabetes was induced in 7-week-old male wild-type mice by a single injection of streptozotocin (150 mg/kg). Pemafibrate (0.3 mg/kg/day) was administered orally for 3 weeks. Untreated mice received vehicle. Circulating levels of eicosanoids and free fatty acids were measured using both gas and liquid chromatography-mass spectrometry. Endothelium-dependent and endothelium-independent vascular responses to acetylcholine and sodium nitroprusside, respectively, were analyzed. Results: Pemafibrate reduced both triglyceride and non-high-density lipoprotein-cholesterol levels ( P <0.01), without affecting body weight. It also decreased circulating levels of AA ( P <0.001), thromboxane B 2 ( P <0.001), prostaglandin E 2 , leukotriene B 4 ( P <0.05), and 5-hydroxyeicosatetraenoic acid ( P <0.001), all of which were elevated by the induction of diabetes. In contrast, the plasma levels of 15-deoxy-Δ 12,14 -prostaglandin J 2 , which declined following diabetes induction, remained unaffected by pemafibrate treatment. In diabetic mice, pemafibrate decreased palmitic acid (PA) and stearic acid concentrations ( P <0.05). Diabetes induction impaired endothelial function, whereas pemafibrate ameliorated it ( P <0.001). The results of ex vivo experiments indicated that eicosanoids or PA impaired endothelial function. Conclusion: Pemafibrate diminished the levels of vasoconstrictive eicosanoids and free fatty acids accompanied by a reduction of triglyceride. These effects may be associated with the improvement of endothelial function by pemafibrate in diabetic mice.
- Published
- 2021
50. Current status of doublet combinations of platinum and fluoropyrimidines using oxaliplatin for advanced gastric cancer
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Hitomi Wake, Shusuke Yagi, Tomomichi Kiyomatsu, Norihiro Kokudo, Masayoshi Terayama, Kazuhiko Yamada, Nobuyuki Takemura, Naoki Enomoto, and Kyoko Nohara
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Cisplatin ,Oncology ,medicine.medical_specialty ,business.industry ,Standard treatment ,Phases of clinical research ,Review ,digestive system diseases ,Oxaliplatin ,Clinical trial ,Regimen ,FOLFOX ,Internal medicine ,Medicine ,business ,Adverse effect ,medicine.drug - Abstract
The most common treatment for advanced gastric cancer (AGC) is systemic chemotherapy. The standard treatment for advanced gastric cancer differs worldwide. In Japan, two phase III clinical trials demonstrated the non-inferiority of S-1 compared with 5-fluorouracil (5-FU) and superiority of cisplatin plus S-1 (CS), compared with S-1, with respect to overall survival (SPIRITS trial). Oxaliplatin (L-OHP) has a favorable toxicity profile compared with cisplatin; hence, a phase III clinical trial (G-SOX trial) demonstrated the progression-free survival (PFS) and overall survival in CS was 5.4 and 13.1 months and those in SOX was 5.5 and 14.1 months, respectively. Serious adverse events were more frequently seen in CS than in SOX. So, SOX is as effective as CS for advanced gastric cancer with favorable safety profile. After the publication of this G-SOX trial, the combination of oral or intravenous 5-FU and various doses of L-OHP have been reported. And FOLFOX6 regimen (FOLFOX: a combination of 1-LV and FU with L-OHP) was approved for the treatment of AGC in Japan in 2017. FOLFOX was promising for patients with severe peritoneal metastasis from AGC, because the FOLFOX regimen does not require hydration and does not include oral agents. This review summarizes the efficacy and safety of doublet combinations of platinum and fluoropyrimidines using L-OHP for advanced gastric cancer.
- Published
- 2021
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