1.A Case of Coronary Artery Bypass Grafting through the Left Thoracotomy after Substernal Gastric Interposition for Carcinoma of the Esophagus
Yasuyuki Kato ; Satoru Miyamoto ; Hirokazu Minamimura ; Takumi Ishikawa ; Tadahiro Murakami ; Hiroyuki Nishi ; Kensuke Ohue ; Yoshihiro Shimizu
Japanese Journal of Cardiovascular Surgery 2003;32(5):276-279
We present here a rare case of coronary artery bypass grafting through a left thoracotomy after substernal gastric interposition for esophageal cancer. A 58-year-old man, who had undergone esophagectomy and substernal gastric interposition 11 years previously, was admitted for cerebral infarction from which he made a good recovery without any complication. At this time, the patient was diagnosed as having coronary artery disease on electrocardiogram. Cardiac catheterization revealed triple vessel disease. Coronary artery bypass grafting to the left anterior descending artery and obtuse marginal branch through a left thoracotomy was performed using a radial artery Y-graft under femorofemoral bypass. The aorta was cross-clamped and the heart was arrested with antegrade cold cardioplegic solution for the distal anastomosis of the left anterior descending artery and the obtuse marginal branch which was embedded within the myocardium. The postoperative angiography showed good coronary flow. Left thoracotomy approach provides a good exposure of the left coronary artery. This approach, therefore, is advocated as an alternative method for cases requiring coronary artery bypass but in which median sternotomy is difficult, such as the present case. The appropriate procedure for the site of thoracotomy, supporting methods, choice of graft, and the site of graft anastomosis should be selected in each patient.
2.Epacl, an exchange protein activated by cAMP, increases cell migration through syndccan clustering, PI3K activation and heparan sulphate production.
Erdene Baljinnyam ; Kousaku Iwatsubo ; Xu Wang ; Coskun Ulucan ; David Lagunoff ; Yoshihiro Ishikawa
Innovation 2008;5(3):52-53
BACKGROUND
The role of epacl, an exchange protein activated by cAMP. in melanoma migration is largely unknown. Heparan sulfate (HS), a major ECM, and syndecan2, a HS-binding protein on the cell surface, play important roles in regulating such migration. Synde- can2, when activated, translocates to lipid-rich plasma microdomains, known as lipid rafts. We thus examined the role of epacl in HS production and syndecan2 transloca¬tion in melanoma migration.
METHODS
SK-MF.L-2, a human melanoma cell line, and migration assays with Boyden cham¬bers were employed.
RESULTS
Activation of Epacl adenoviral Epacl overexprcssiotl or HpMeOPT, at) Epac-specif- ic cAMP analog, significantly increased cell migration in a time- and dose-dependent manner. Epacl also increased HS production by 2-fold, and the removal of HS abol¬ished Epacl-induced migration. Epacl also increased expression of N-deacetylase/N- sulfotransferase-1 (NDST-1), a key synthetic enzyme for HS. Sucrose gradient frac¬tionation showed that Epacl increased syndecan2 translocation to rafts. In addition, disruption of rafts with lipid depletion abolished Epacl-induced migration.
SUMMARY
Epacl increased migration in malignant melanoma through HS production and syn- decan2 translocation to rafts.
3. Epacl, an exchange protein activated by cAMP, increases cell migration through syndccan clustering, PI3K activation and heparan sulphate production.
Erdene BALJINNYAM ; Kousaku IWATSUBO ; Xu WANG ; Coskun ULUCAN ; David LAGUNOFF ; Yoshihiro ISHIKAWA
Innovation 2008;5(3):52-53
BACKGROUNDThe role of epacl, an exchange protein activated by cAMP. in melanoma migration is largely unknown. Heparan sulfate (HS), a major ECM, and syndecan2, a HS-binding protein on the cell surface, play important roles in regulating such migration. Synde- can2, when activated, translocates to lipid-rich plasma microdomains, known as lipid rafts. We thus examined the role of epacl in HS production and syndecan2 transloca¬tion in melanoma migration. METHODSSK-MF.L-2, a human melanoma cell line, and migration assays with Boyden cham¬bers were employed.RESULTSActivation of Epacl adenoviral Epacl overexprcssiotl or HpMeOPT, at) Epac-specif- ic cAMP analog, significantly increased cell migration in a time- and dose-dependent manner. Epacl also increased HS production by 2-fold, and the removal of HS abol¬ished Epacl-induced migration. Epacl also increased expression of N-deacetylase/N- sulfotransferase-1 (NDST-1), a key synthetic enzyme for HS. Sucrose gradient frac¬tionation showed that Epacl increased syndecan2 translocation to rafts. In addition, disruption of rafts with lipid depletion abolished Epacl-induced migration.SUMMARYEpacl increased migration in malignant melanoma through HS production and syn- decan2 translocation to rafts.
4.9-4 Education Given at Jichi Medical University's Dormitory during the COVID-19 Pandemic: Strategies and Challenges in a Boarding Medical College
Yosikazu NAKAMURA ; Yoshihiro ITAI ; Nobuko MAKINO ; Masaaki SATO ; Shigeo NAGASHIMA ; Yukiko ISHIKAWA ; Kenji KUROIWA ; Teppei SASAHARA ; Yasuko NODA ; Masami MATSUMURA ; Shizukiyo ISHIKAWA ; Masanori OGAWA ; Akinori YAMABE ; Yoshikazu ASADA
Medical Education 2020;51(3):306-307
5.Integrating HIV, hepatitis B and syphilis screening and treatment through the Maternal, Newborn and Child Health platform to reach global elimination targets
Joseph WOODRING ; Naoko ISHIKAWA ; Mari NAGAI ; Maya MALARSKI ; Yoshihiro TAKASHIMA ; Howard SOBEL ; Ying-Ru LO
Western Pacific Surveillance and Response 2017;8(4):1-5
Every year, an estimated 180 000 babies in the Western Pacific Region are infected by hepatitis B, 13 000 by syphilis and 1400 by HIV through mother-to-child transmission.1 These infections can be largely prevented by antenatal screening, treatment and timely vaccination for newborns. Despite challenges in controlling each disease, major achievements have been made. National immunization programmes have reduced the regional hepatitis B prevalence from over 8% in 1990 to 0.93% among children born in 2012. In addition, HIV testing and treatment have helped keep the regional prevalence of HIV infections at 0.1%. In contrast, the number of maternal syphilis cases is still high in the Western Pacific Region, with an estimated 45 million cases in 2012. Elimination of mother-to-child transmission of these infections cannot be achieved through vertically applied programming and require using and augmenting to the shared Maternal, Newborn and Child Health platform to coordinate, integrate and enable cost efficiencies for these elimination efforts. The Regional Framework for Triple Elimination of Mother-to-Child Transmission of HIV, Hepatitis B and Syphilis in Asia and the Pacific 2018–2030 offers such a coordinated approach towards achieving the triple elimination of mother-to-child transmission of HIV, hepatitis B and syphilis and provides guidance for decision-makers, managers and health professionals working in programmes addressing maternal, newborn and child health, HIV, hepatitis, sexually transmitted infections and immunization.
6.Production of cloned sei whale (Balaenoptera borealis) embryos by interspecies somatic cell nuclear transfer using enucleated pig oocytes.
Eunsong LEE ; Mohammad Musharraf Uddin BHUIYAN ; Hiroyuki WATANABE ; Kohji MATSUOKA ; Yoshihiro FUJISE ; Hajime ISHIKAWA ; Yutaka FUKUI
Journal of Veterinary Science 2009;10(4):285-292
In this study, we examined the feasibility of using subzonal cell injection with electrofusion for interspecies somatic cell nuclear transfer (iSCNT) to produce sei whale embryos and to improve their developmental capacity by investigating the effect of osmolarity and macromolecules in the culture medium on the in vitro developmental capacity. Hybrid embryos produced by the electrofusion of fetal whale fibroblasts with enucleated porcine oocytes were cultured in modified porcine zygote medium-3 to examine the effects of osmolarity and fetal serum on their in vitro developmental capacity. More than 66% of the whale somatic cells successfully fused with the porcine oocytes following electrofusion. A portion (60~81%) of the iSCNT whale embryos developed to the two- to four-cell stages, but no embryos were able to reach the blastocyst stage. This developmental arrest was not overcome by increasing the osmolarity of the medium to 360 mOsm or by the addition of fetal bovine or fetal whale serum. Our results demonstrate that sei whale-porcine hybrid embryos may be produced by SCNT using subzonal injection and electrofusion. The pig oocytes partly supported the remodeling and reprogramming of the sei whale somatic cell nuclei, but they were unable to support the development of iSCNT whale embryos to the blastocyst stage.
Animals
;
Cloning, Organism/*veterinary
;
Culture Media
;
Embryo, Mammalian
;
Karyotyping
;
Nuclear Transfer Techniques/*veterinary
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*Oocytes
;
Swine/*embryology
;
Whales/*embryology
7.Transient Receptor Potential Vanilloid 1-Immunoreactive Innervation Increases in Fractured Rat Femur.
Yuya KAWARAI ; Miyako SUZUKI ; Kensuke YOSHINO ; Gen INOUE ; Sumihisa ORITA ; Kazuyo YAMAUCHI ; Yasuchika AOKI ; Tetsuhiro ISHIKAWA ; Masayuki MIYAGI ; Hiroto KAMODA ; Go KUBOTA ; Yoshihiro SAKUMA ; Yasuhiro OIKAWA ; Kazuhide INAGE ; Takeshi SAINOH ; Jun SATO ; Junichi NAKAMURA ; Masashi TAKASO ; Tomoaki TOYONE ; Kazuhisa TAKAHASHI ; Seiji OHTORI
Yonsei Medical Journal 2014;55(1):185-190
PURPOSE: Pain from vertebral or femoral neck fractures is a particularly important problem in clinical orthopaedics. Transient receptor potential vanilloid 1 (TRPV1) is a ligand-gated nonselective cation channel, and there are recent reports on an association between bone pain and TRPV1. However, an increase in TRPV1 activity has not been reported following femoral fracture. MATERIALS AND METHODS: We applied a neurotracer [Fluoro-gold (FG)] onto femur to detect dorsal root ganglia (DRGs) innervating the cortex of the femur in 30 Sprague Dawley rats. Seven days after application, a closed mid-diaphyseal fracture of the femur was performed. FG labeled TRPV1-immunoreactive (ir) DRGs innervating the femur were examined in nonfractured controls, and 3 days, 1 week, 2 weeks, and 4 weeks after fracture. We evaluated bone healing of the femur and compared the ratio of TRPV1-ir DRG neurons innervating the femur at the time points. RESULTS: Four weeks after fracture, complete bone union was observed. There was no significant difference in the ratio of FG labeled DRG neurons to total DRG neurons at each time point. The percentages of TRPV1-ir neurons in DRGs innervating the femur at 3 days and 1 week after fracture were significantly higher than those in control, 2 weeks, and 4 weeks after fracture (p<0.05). CONCLUSION: Fracture induced an increase of TRPV1-ir neurons in DRGs innervating the fractured femur within 3 days, and decreased during bone healing over 4 weeks. These findings show that TRPV1 may play a role in sensory sensation of bone fracture pain.
Animals
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Female
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Femur/*innervation/*metabolism
;
Immunohistochemistry
;
Rats
;
Rats, Sprague-Dawley
;
TRPV Cation Channels/*metabolism
8.Efficacy of Combination of Meloxicam and Pregabalin for Pain in Knee Osteoarthritis.
Seiji OHTORI ; Gen INOUE ; Sumihisa ORITA ; Masashi TAKASO ; Yawara EGUCHI ; Nobuyasu OCHIAI ; Shunji KISHIDA ; Kazuki KUNIYOSHI ; Yasuchika AOKI ; Tetsuhiro ISHIKAWA ; Masayuki MIYAGI ; Hiroto KAMODA ; Miyako SUZKUKI ; Junichi NAKAMURA ; Gou KUBOTA ; Yoshihiro SAKUMA ; Yasuhiro OIKAWA ; Tomoaki TOYONE ; Kazuhide INAGE ; Takeshi SAINOH ; Kazuyo YAMAUCHI ; Kazuhisa TAKAHASHI
Yonsei Medical Journal 2013;54(5):1253-1258
PURPOSE: Osteoarthritic pain is largely considered to be inflammatory pain. Sensory nerve fibers innervating the knee have been shown to be significantly damaged in rat models of knee osteoarthritis (OA) in which the subchondral bone junction is destroyed, and this induces neuropathic pain (NP). Pregabalin was developed as a pain killer for NP; however, there are no reports on pregabalin use in OA patients. The purpose of this study was to investigate the efficacy of pregabalin for pain in OA patients. MATERIALS AND METHODS: Eighty-nine knee OA patients were evaluated in this randomized prospective study. Patients were divided into meloxicam, pregabalin, and meloxicam+pregabalin groups. Pain scores were evaluated before and 4 weeks after drug application using a visual analogue scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Pain scales among groups were compared using a Kruskal-Wallis test. RESULTS: Before drug application, there was no significant difference in VAS and WOMAC scores among the three groups (p>0.05). Significant pain relief was seen in the meloxicam+pregabalin group in VAS at 1, 2, and 4 weeks, and WOMAC score at 4 weeks, compared with the other groups (p<0.05). No significant pain relief was seen in the meloxicam only group in VAS during 4 weeks and WOMAC score at 4 weeks compared with the pregabalin only group (p>0.05). CONCLUSION: Meloxicam+pregabalin was effective for pain in OA patients. This finding suggests that OA pain is a combination of inflammatory and NP.
Aged
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Aged, 80 and over
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Drug Therapy, Combination/adverse effects
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Female
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Humans
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Male
;
Middle Aged
;
Osteoarthritis, Knee/*drug therapy
;
Pain Measurement
;
Thiazines/administration & dosage/adverse effects/*therapeutic use
;
Thiazoles/administration & dosage/adverse effects/*therapeutic use
;
gamma-Aminobutyric Acid/administration & dosage/adverse effects/*analogs & derivatives/therapeutic use
9.Clinical Incidence of Sacroiliac Joint Arthritis and Pain after Sacropelvic Fixation for Spinal Deformity.
Seiji OHTORI ; Takeshi SAINOH ; Masashi TAKASO ; Gen INOUE ; Sumihisa ORITA ; Yawara EGUCHI ; Junichi NAKAMURA ; Yasuchika AOKI ; Tetsuhiro ISHIKAWA ; Masayuki MIYAGI ; Gen ARAI ; Hiroto KAMODA ; Miyako SUZUKI ; Gou KUBOTA ; Yoshihiro SAKUMA ; Yasuhiro OIKAWA ; Masashi YAMAZAKI ; Tomoaki TOYONE ; Kazuhisa TAKAHASHI
Yonsei Medical Journal 2012;53(2):416-421
PURPOSE: Sacroiliac fixation using iliac screws for highly unstable lumbar spine has been reported with an improved fusion rate and clinical results. On the other hand, there is a potential for clinical problems related to iliac fixation, including late sacroiliac joint arthritis and pain. MATERIALS AND METHODS: Twenty patients were evaluated. Degenerative scoliosis was diagnosed in 7 patients, failed back syndrome in 6 patients, destructive spondyloarthropathy in 4 patients, and Charcot spine in 3 patients. All patients underwent posterolateral fusion surgery incorporating lumbar, S1 and iliac screws. We evaluated the pain scores, bone union, and degeneration of sacroiliac joints by X-ray imaging and computed tomography before and 3 years after surgery. For evaluation of low back and buttock pain from sacroiliac joints 3 years after surgery, lidocaine was administered in order to examine pain relief thereafter. RESULTS: Pain scores significantly improved after surgery. All patients showed bone union at final follow-up. Degeneration of sacroiliac joints was not seen in the 20 patients 3 years after surgery. Patients showed slight low back and buttock pain 3 years after surgery. However, not all patients showed relief of the low back and buttock pain after injection of lidocaine into the sacroiliac joint, indicating that their pain did not originate from sacroiliac joints. CONCLUSION: The fusion rate and clinical results were excellent. Also, degeneration and pain from sacroiliac joints were not seen within 3 years after surgery. We recommend sacroiliac fixation using iliac screws for highly unstable lumbar spine.
Aged
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Arthritis/*surgery
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Bone Screws
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Female
;
Humans
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Low Back Pain/diagnosis/epidemiology
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Lumbar Vertebrae/*surgery
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Male
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Middle Aged
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Pain/diagnosis/*epidemiology
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Sacroiliac Joint/*immunology/*pathology
10.Mini-Open Anterior Retroperitoneal Lumbar Interbody Fusion: Oblique Lateral Interbody Fusion for Lumbar Spinal Degeneration Disease.
Seiji OHTORI ; Sumihisa ORITA ; Kazuyo YAMAUCHI ; Yawara EGUCHI ; Nobuyasu OCHIAI ; Shunji KISHIDA ; Kazuki KUNIYOSHI ; Yasuchika AOKI ; Junichi NAKAMURA ; Tetsuhiro ISHIKAWA ; Masayuki MIYAGI ; Hiroto KAMODA ; Miyako SUZUKI ; Gou KUBOTA ; Yoshihiro SAKUMA ; Yasuhiro OIKAWA ; Kazuhide INAGE ; Takeshi SAINOH ; Jun SATO ; Kazuki FUJIMOTO ; Yasuhiro SHIGA ; Koki ABE ; Tomoaki TOYONE ; Gen INOUE ; Kazuhisa TAKAHASHI
Yonsei Medical Journal 2015;56(4):1051-1059
PURPOSE: Surgery for lumbar spinal degeneration disease is widely performed. While posterior decompression and fusion are popular, anterior lumbar interbody fusion (ALIF) is also used for treatment. Extreme lateral interbody fusion (XLIF) is commonly used for noninvasive ALIF; however, several complications, such as spinal nerve and psoas muscle injury, have been reported. In the current study, we examined the clinical efficacy and complications of oblique lateral interbody fusion (OLIF) for lumbar spinal degeneration disease. MATERIALS AND METHODS: Thirty-five patients with degenerated spondylolisthesis, discogenic pain, and kyphoscoliosis were examined. All patients underwent OLIF surgery (using a cage and bone graft from the iliac crest) with or without posterior decompression, without real-time electromyography monitoring. Posterior screws were used in all patients. Visual analog scale (VAS) score and Oswestry Disability Index (ODI) were evaluated before and 6 months after surgery. Surgical complications were also evaluated. RESULTS: Pain scores significantly improved after surgery, compared to those before surgery (p<0.05). There was no patient who underwent revision surgery. There was no spinal nerve, major vessel, peritoneal, or urinary injury. Few patients showed symptoms from psoas invasion. CONCLUSION: OLIF surgery produced good surgical results without any major complication.
Adult
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Aged
;
Decompression, Surgical/*methods
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Electromyography
;
Female
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Humans
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Lumbar Vertebrae/surgery
;
Male
;
Middle Aged
;
Pain
;
Pain Measurement
;
Scoliosis/*surgery
;
Spinal Diseases/surgery
;
Spinal Fusion/*methods
;
Spondylolisthesis/*surgery
;
Treatment Outcome
;
Young Adult