1.Roles of Capsule Endoscopy and Balloon-Assisted Enteroscopy in the Optimal Management of Small Bowel Bleeding
Hani ABUTALIB ; Tomonori YANO ; Satoshi SHINOZAKI ; Alan Kawarai LEFOR ; Hironori YAMAMOTO
Clinical Endoscopy 2020;53(4):402-409
The small bowel had long been considered a dark unapproachable tunnel until the invention of capsule endoscopy and doubleballoon enteroscopy in the 21st century, which revolutionized the diagnosis and management of small bowel diseases, including bleeding. Various imaging modalities such as computed tomographic enterography, angiography, capsule endoscopy, and balloonassisted enteroscopy play vital roles in the diagnosis and management of small bowel bleeding. The choice of modality to use and timing of application differ according to the availability of the modalities, patient’s history, and physician’s experience. Small bowel bleeding is managed using different strategies as exemplified by medical treatment, interventional radiology, endoscopic therapy, or surgical intervention. Balloon-assisted enteroscopy enables endoscopic interventions to control small bowel bleeding, including electrocautery, argon plasma coagulation, clip application, and tattooing as a prelude to surgery. In this article, we clarify the recent approaches to the optimal diagnosis and management of patients with small bowel bleeding.
2.A Case of Aortic Valve Replacement in Patient with Chronic Idiopathic Thrombocytopenic Purpura.
Hiroyuki Hirose ; Motomi Shiono ; Yukihiko Orime ; Shinya Yagi ; Tomonori Yamamoto ; Haruhiko Okumura ; Mitsumasa Hata ; Nanao Negishi ; Yukiyasu Sezai ; Yoshihiro Matsukawa
Japanese Journal of Cardiovascular Surgery 2000;29(6):400-403
A 66-year-old woman with aortic stenosis and idiopathic thrombocytopenic purpura (ITP) underwent concomitant splenectomy and aortic valve replacement (AVR). High-dose trans-venous gamma-globulin therapy (400mg/kg/day) was performed for five days before surgery. The number of platelet, which was 6.0×104/mm3 on admission slighty increased to 7.0×104/mm3 before surgery. The aortic valve was replaced by an ATS 19mm prosthesis using cardiopulmonary bypass. Platelets were transfused postoperatively. Perioperative hemorrhage was moderate, and the postoperative course was uneventful. This was the second case we treated by concomitant cardiac surgery and splenectomy. It was safely performed after high-dose trans-venous gamma-globulin therapy.
3.A Case of Surgical Treatment for Type A Aortic Dissection Associated with Proximal Descending Thoracic Aortic Aneurysm.
Tetsuya Niino ; Motomi Shiono ; Yukihiko Orime ; Shinya Yagi ; Tomonori Yamamoto ; Syunichi Kimura ; Mitsumasa Hata ; Shinsuke Choh ; Nanao Negishi ; Yukiyasu Sezai
Japanese Journal of Cardiovascular Surgery 2001;30(2):77-79
A 63-year-old man suffered from type A acute aortic dissection associated with descending thoracic aortic aneurysm and coronary stenosis. He was treated surgically 49 days after onset of acute aortic dissection. Deep hypothermic selective cerebral perfusion was carried out for brain protection. It revealed the aneurysm, 51mm in diameter, located just distal to the aortic arch, and an intimal tear of the dissection located posterior wall of aneurysm. The total arch was replaced with 24mm vascular graft and CABG (LITA-to-seg. 8) was carried out. The postoperative course was uneventful and he was discharged on the 18th postoperative day.
5.How and When Can Cardiovascular Surgeons Get a Day Off ?? No.2
Kumiko WADA ; Takafumi ABE ; Eigo IKUSHIMA ; Katsuya KAWAGOE ; Tomonori KOGA ; Shuji NAGATOMI ; Hiromitsu TERATANI ; Takeaki HARADA ; Shotaro HIGA ; Eijiro NOGAMI ; Hirofumi YAMAMOTO
Japanese Journal of Cardiovascular Surgery 2020;49(2):2-U1-2-U5
We investigated how cardiovascular surgeons get a day off.
6.Differences in Hematological and Clinical Features Between Essential Thrombocythemia Cases With JAK2- or CALR-Mutations.
Yoko KUBUKI ; Kotaro SHIDE ; Takuro KAMEDA ; Takumi YAMAJI ; Masaaki SEKINE ; Ayako KAMIUNTEN ; Keiichi AKIZUKI ; Haruko SHIMODA ; Yuki TAHIRA ; Kenichi NAKAMURA ; Hiroo ABE ; Tadashi MIIKE ; Hisayoshi IWAKIRI ; Yoshihiro TAHARA ; Mitsue SUETA ; Kanna HASHIMOTO ; Shojiro YAMAMOTO ; Satoru HASUIKE ; Tomonori HIDAKA ; Kenji NAGATA ; Akira KITANAKA ; Kazuya SHIMODA
Annals of Laboratory Medicine 2017;37(2):159-161
No abstract available.
Adolescent
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Adult
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Age Factors
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Aged
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Aged, 80 and over
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Amino Acid Sequence
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Calreticulin/*genetics
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Child
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DNA/chemistry/genetics/metabolism
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Exons
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Female
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Humans
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Janus Kinase 2/*genetics
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Male
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Middle Aged
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Molecular Sequence Data
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Polymorphism, Single Nucleotide
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Receptors, Thrombopoietin/genetics
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Sequence Analysis, DNA
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Sex Factors
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Thrombocythemia, Essential/*diagnosis/genetics
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Young Adult
7.Glycosylation engineering of therapeutic IgG antibodies: challenges for the safety, functionality and efficacy.
Yusuke MIMURA ; Toshihiko KATOH ; Radka SALDOVA ; Roisin O'FLAHERTY ; Tomonori IZUMI ; Yuka MIMURA-KIMURA ; Toshiaki UTSUNOMIYA ; Yoichi MIZUKAMI ; Kenji YAMAMOTO ; Tsuneo MATSUMOTO ; Pauline M RUDD
Protein & Cell 2018;9(1):47-62
Glycosylation of the Fc region of IgG has a profound impact on the safety and clinical efficacy of therapeutic antibodies. While the biantennary complex-type oligosaccharide attached to Asn297 of the Fc is essential for antibody effector functions, fucose and outer-arm sugars attached to the core heptasaccharide that generate structural heterogeneity (glycoforms) exhibit unique biological activities. Hence, efficient and quantitative glycan analysis techniques have been increasingly important for the development and quality control of therapeutic antibodies, and glycan profiles of the Fc are recognized as critical quality attributes. In the past decade our understanding of the influence of glycosylation on the structure/function of IgG-Fc has grown rapidly through X-ray crystallographic and nuclear magnetic resonance studies, which provides possibilities for the design of novel antibody therapeutics. Furthermore, the chemoenzymatic glycoengineering approach using endoglycosidase-based glycosynthases may facilitate the development of homogeneous IgG glycoforms with desirable functionality as next-generation therapeutic antibodies. Thus, the Fc glycans are fertile ground for the improvement of the safety, functionality, and efficacy of therapeutic IgG antibodies in the era of precision medicine.
Animals
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Antibodies, Monoclonal
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adverse effects
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pharmacokinetics
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therapeutic use
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Glycosylation
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Humans
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Immunoglobulin G
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chemistry
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metabolism
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Protein Engineering
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methods
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Receptors, Fc
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chemistry
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metabolism
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Treatment Outcome