2.A Case of Severe Aortic Stenosis Accompanied by Porcelain Aorta Treated with an Apicoaortic Valved Conduit
Norihiko Saitoh ; Kazuo Yamamoto ; Satoshi Tanaka ; Chizuo Kikuchi ; Tsutomu Sugimoto ; Shigetaka Kasuya
Japanese Journal of Cardiovascular Surgery 2004;33(3):208-212
The patient was a 70-year-old woman with severe aortic stenosis and familial hyperlipidemia which was diagnosed in 1994. The patient was admitted as an emergency case due to syncope in 2002. According to ultrasound cardiography (UCG), the pressure gradient of the aortic valve was 120.7mmHg, and the diameter of the aortic valve annulus was 16.7mm. Computed tomography showed porcelain aorta from the annulus of aortic valve to the ascending aorta. On cardiac catheterization, the pressure gradient was 96mmHg, AVA was 0.4cm2, and the ejection fraction was 38.7%. Since these findings suggested that conventional AVR was difficult, thoracotomy was performed at the left 5th intercostal level, and apicoaortic valved conduit (valved graft: SJM19HP, Intergard 22mm+Medtronic apical LV connector) was implanted. Postoperative cine MRI showed that most of the cardiac output (87%, 3.29l/min) flowed through the conduit, with the flow via the aortic valve accounting for 13%, 0.51l/min. This surgical procedure can be an effective alternative when conventional AVR is difficult.
4.What Is the Most Effective Drug Delivery System for Cisplatin during the Treatment of Hepatic Tumors with Single-Session Transcatheter Chemotherapy? A Pilot Study.
Yusuke KAWAMURA ; Kenji IKEDA ; Taito FUKUSHIMA ; Yuya SEKO ; Tasuku HARA ; Hitomi SEZAKI ; Tetsuya HOSAKA ; Norio AKUTA ; Masahiro KOBAYASHI ; Satoshi SAITOH ; Fumitaka SUZUKI ; Yoshiyuki SUZUKI ; Yasuji ARASE ; Hiromitsu KUMADA
Gut and Liver 2013;7(5):576-584
BACKGROUND/AIMS: The aim of this study was to determine the pharmacodynamics of cisplatin following three different treatment procedures for intrahepatic arterial infusion therapy for hepatocellular carcinoma (HCC). METHODS: We divided 13 HCC patients into the following three groups: group A, lone injection of cisplatin (n=3); group B, combined injection of cisplatin and lipiodol, with embolization using small gelatin cubes (GCs) (n=5); and group C, injection of suspended lipiodol with cisplatin powder, with embolization using small GCs (n=5). In each group, the free cisplatin concentration in the hepatic vein was measured at 0, 5, 10, and 30 minutes. RESULTS: The mean free cisplatin concentrations were as follows. For group A, the mean was 48.58 microg/mL at 0 minute, 7.31 microg/mL at 5 minutes, 5.70 microg/mL at 10 minutes, and 7.15 microg/mL at 30 minutes. For the same time points, for group B, the concentrations were 8.66, 4.23, 3.22, and 1.65 microg/mL, respectively, and for group C, the concentrations were 4.81, 2.61, 2.52, and 1.75 microg/mL, respectively. The mean area under the curve (AUC)0-infinity for the free cisplatin concentration was 7.80 in group A, 2.48 in group B, and 2.27 in group C. The AUC0-infinity for the free cisplatin concentration gradually decreased, from group A to group C. CONCLUSIONS: These results indicate that the combination of lipiodol and small GCs may be useful for delaying cisplatin drainage from the liver.
Carcinoma, Hepatocellular
;
Cisplatin
;
Drainage
;
Drug Delivery Systems
;
Ethiodized Oil
;
Gelatin
;
Hepatic Veins
;
Humans
;
Liver
;
Pilot Projects
5.Relationships between Genetic Variations of PNPLA3, TM6SF2 and Histological Features of Nonalcoholic Fatty Liver Disease in Japan.
Norio AKUTA ; Yusuke KAWAMURA ; Yasuji ARASE ; Fumitaka SUZUKI ; Hitomi SEZAKI ; Tetsuya HOSAKA ; Masahiro KOBAYASHI ; Mariko KOBAYASHI ; Satoshi SAITOH ; Yoshiyuki SUZUKI ; Kenji IKEDA ; Hiromitsu KUMADA
Gut and Liver 2016;10(3):437-445
BACKGROUND/AIMS: It is important to determine the noninvasive parameters of histological features in nonalcoholic fatty liver disease (NAFLD). The aim of this study was to investigate the value of genetic variations as surrogate markers of histological features. METHODS: The parameters that affected the histological features of NAFLD were investigated in 211 Japanese patients with biopsy-proven NAFLD. The relationships between genetic variations in PNPLA3 rs738409 or TM6SF2 rs58542926 and histological features were analyzed. Furthermore, the impact of genetic variations that affected the pathological criteria for the diagnosis of nonalcoholic steatohepatitis (NASH) (Matteoni classification and NAFLD activity score) was evaluated. RESULTS: The fibrosis stage of PNPLA3 GG was significantly more progressive than that of CG by multiple comparisons. Multivariate analysis identified PNPLA3 genotypes as predictors of fibrosis of stage 2 or more, but the impact tended to decrease at stage 3 or greater. There were no significant differences among the histological features of the three genotypes of TM6SF2. PNPLA3 genotypes partly affected the definition of NASH by the NAFLD activity score, but TM6SF2 genotypes did not affect the definition of NASH. CONCLUSIONS: In Japanese patients with biopsy-proven NAFLD, PNPLA3 genotypes may partly affect histological features, including stage of fibrosis, but the TM6SF2 genotype does not affect histological features.
Asian Continental Ancestry Group
;
Biological Markers
;
Classification
;
Diagnosis
;
Fatty Liver*
;
Fibrosis
;
Genetic Variation*
;
Genotype
;
Humans
;
Japan*
;
Multivariate Analysis
6.Noninvasive Assessment of Advanced Fibrosis Based on Hepatic Volume in Patients with Nonalcoholic Fatty Liver Disease.
Tatsuya HAYASHI ; Satoshi SAITOH ; Kei FUKUZAWA ; Yoshinori TSUJI ; Junji TAKAHASHI ; Yusuke KAWAMURA ; Norio AKUTA ; Masahiro KOBAYASHI ; Kenji IKEDA ; Takeshi FUJII ; Tosiaki MIYATI ; Hiromitsu KUMADA
Gut and Liver 2017;11(5):674-683
BACKGROUND/AIMS: Noninvasive liver fibrosis evaluation was performed in patients with nonalcoholic fatty liver disease (NAFLD). We used a quantitative method based on the hepatic volume acquired from gadoxetate disodium-enhanced (Gd-EOB-DTPA-enhanced) magnetic resonance imaging (MRI) for diagnosing advanced fibrosis in patients with NAFLD. METHODS: A total of 130 patients who were diagnosed with NAFLD and underwent Gd-EOB-DTPA-enhanced MRI were retrospectively included. Histological data were available for 118 patients. Hepatic volumetric parameters, including the left hepatic lobe to right hepatic lobe volume ratio (L/R ratio), were measured. The usefulness of the L/R ratio for diagnosing fibrosis ≥F3–4 and F4 was assessed using the area under the receiver operating characteristic (AUROC) curve. Multiple regression analysis was performed to identify variables (age, body mass index, serum fibrosis markers, and histological features) that were associated with the L/R ratio. RESULTS: The L/R ratio demonstrated good performance in differentiating advanced fibrosis (AUROC, 0.80; 95% confidence interval, 0.72 to 0.88) from cirrhosis (AUROC, 0.87; 95% confidence interval, 0.75 to 0.99). Multiple regression analysis showed that only fibrosis was significantly associated with the L/R ratio (coefficient, 0.121; p<0.0001). CONCLUSIONS: The L/R ratio, which is not influenced by pathological parameters other than fibrosis, is useful for diagnosing cirrhosis in patients with NAFLD.
Body Mass Index
;
Fibrosis*
;
Humans
;
Liver Cirrhosis
;
Magnetic Resonance Imaging
;
Methods
;
Non-alcoholic Fatty Liver Disease*
;
Retrospective Studies
;
ROC Curve
7.Transcatheter Arterial Chemotherapy with Miriplatin for Hepatocellular Carcinoma Patients with Chronic Renal Failure: Report of Three Cases.
Norihiro IMAI ; Kenji IKEDA ; Yuya SEKO ; Yusuke KAWAMURA ; Hitomi SEZAKI ; Tetsuya HOSAKA ; Norio AKUTA ; Masahiro KOBAYASHI ; Satoshi SAITOH ; Fumitaka SUZUKI ; Yoshiyuki SUZUKI ; Yasuji ARASE ; Hiromitsu KUMADA
Gut and Liver 2013;7(2):246-251
Miriplatin is a novel lipophilic platinum complex that was developed to treat hepatocellular carcinoma (HCC). Although HCC patients frequently have coexisting chronic renal failure, little prospective data are available regarding the clinical toxicity of chemotherapeutic agents used to treat HCC patients with chronic renal failure. In a phase II study, the plasma concentration of total platinum in patients who received miriplatin was very low, and no severe renal toxicity caused by miriplatin injection was reported. Here, we present three cases of HCC with stage 4 chronic renal failure who received transcatheter arterial chemotherapy with miriplatin. All cases were male, ages 72, 84, and 83 years, and had serum creatinine levels of 2.3, 1.6, and 1.9 mg/dL, respectively. Their estimated glomerular filtration rates were 21.9, 20.3, and 22.2 mL/min, respectively. All cases were treated for unresectable HCC with transcatheter arterial chemotherapy with miriplatin. No serious adverse events were observed, and serum creatinine levels did not elevate, even in the patient who experienced renal failure caused by cisplatin administration. These results might suggest that transcatheter arterial chemotherapy with miriplatin can be safely used in HCC patients with chronic renal failure.
Carcinoma, Hepatocellular
;
Cisplatin
;
Creatinine
;
Glomerular Filtration Rate
;
Humans
;
Kidney Failure, Chronic
;
Male
;
Organoplatinum Compounds
;
Plasma
;
Platinum
;
Renal Insufficiency
8.Multiple Giant Coronary Artery Aneurysms with Coronary-Pulmonary Artery Fistula
Daiki SAITOH ; Naoya SAKODA ; Azuma TABAYASHI ; Jyunichi KOIZUMI ; Satoshi OOSAWA ; Hajime KIN
Japanese Journal of Cardiovascular Surgery 2023;52(6):422-426
Giant coronary artery aneurysms are relatively rare and are usually associated with Kawasaki disease, atherosclerosis, congenital disease, or trauma. Although a coronary-pulmonary artery fistula is a known complication, clear guidelines for treatment of this condition remain unavailable. We report a case of multiple giant coronary artery aneurysms associated with a coronary-pulmonary artery fistula in a patient who underwent fistulotomy, aneurysmectomy, and coronary artery bypass graft surgery. A 66-year-old woman was initially evaluated by her primary care physician following right breast cancer surgery. She denied any specific symptoms; however, she was referred to our hospital for evaluation of an abnormal shadow detected on chest radiography. Contrast-enhanced computed tomography (CT) performed at our hospital revealed multiple giant coronary artery aneurysms(approximately 45 mm in size), as well as right and left coronary-pulmonary artery fistulas. We performed simultaneous aneurysmectomy, fistula resection, and coronary artery bypass grafting for management of the giant coronary artery aneurysms concomitant with coronary-pulmonary artery fistulas. Threedimensional CT was useful for accurate imaging of the location of the coronary artery aneurysms, fistula vessels, and the left anterior descending, and left circumflex arteries. It is essential to accurately delineate the boundary between the aneurysms and healthy coronary arteries and fistula vessels, and coronary artery bypass graft surgery should be performed if necessary. We report a rare case of the aforementioned clinical condition, together with a literature review.
9.Prevalence of molar incisor hypomineralization and regional differences throughout Japan.
Masato SAITOH ; Yuki NAKAMURA ; Mika HANASAKI ; Issei SAITOH ; Yuji MURAI ; Yoshihito KURASHIGE ; Satoshi FUKUMOTO ; Yukiko ASAKA ; Masaaki YAMADA ; Michikazu SEKINE ; Haruaki HAYASAKI ; Shigenari KIMOTO
Environmental Health and Preventive Medicine 2018;23(1):55-55
BACKGROUND:
Molar incisor hypomineralization (MIH) frequently occurs in children worldwide. However, MIH prevalence throughout Japan has not yet been investigated. The purpose of this study was to clarify MIH prevalence rates and to consider potential regional differences throughout Japan.
METHODS:
A total of 4496 children aged 7-9 years throughout Japan were evaluated in this study. MIH prevalence rates among children were evaluated in eight regions throughout Japan. A child's residence was defined as the mother's residence during pregnancy. The localization of demarcated opacities and enamel breakdown was recorded on a standard code form using a guided record chart. Logistic regression analysis was used to evaluate whether MIH prevalence rates differed among age groups, sex, and regions.
RESULTS:
The overall prevalence of MIH in Japan was 19.8%. The prevalence of MIH was 14.0% in the Hokkaido region, 11.7% in the Tohoku region, 18.5% in the Kanto Shin-Etsu region, 19.3% in the Tokai Hokuriku region, 22.3% in the Kinki region, 19.8% in the Chugoku region, 28.1% in the Shikoku region, and 25.3% in the Kyushu region. These regional differences were statistically significant. Moreover, MIH prevalence rates decreased with age. No significant sex differences in MIH prevalence rates were demonstrated.
CONCLUSIONS
To our knowledge, this is the first MIH study carried out in several regions throughout Japan. Regional differences existed in MIH prevalence rates; particularly, MIH occurred more frequently in children residing in southwestern areas than those in northeastern areas of Japan.
Child
;
Dental Enamel Hypoplasia
;
epidemiology
;
etiology
;
Female
;
Humans
;
Japan
;
epidemiology
;
Male
;
Prevalence
10.PiggyBac transposon-mediated gene delivery efficiently generates stable transfectants derived from cultured primary human deciduous tooth dental pulp cells (HDDPCs) and HDDPC-derived iPS cells.
Emi INADA ; Issei SAITOH ; Satoshi WATANABE ; Reiji AOKI ; Hiromi MIURA ; Masato OHTSUKA ; Tomoya MURAKAMI ; Tadashi SAWAMI ; Youichi YAMASAKI ; Masahiro SATO
International Journal of Oral Science 2015;7(3):144-154
The ability of human deciduous tooth dental pulp cells (HDDPCs) to differentiate into odontoblasts that generate mineralized tissue holds immense potential for therapeutic use in the field of tooth regenerative medicine. Realization of this potential depends on efficient and optimized protocols for the genetic manipulation of HDDPCs. In this study, we demonstrate the use of a PiggyBac (PB)-based gene transfer system as a method for introducing nonviral transposon DNA into HDDPCs and HDDPC-derived inducible pluripotent stem cells. The transfection efficiency of the PB-based system was significantly greater than previously reported for electroporation-based transfection of plasmid DNA. Using the neomycin resistance gene as a selection marker, HDDPCs were stably transfected at a rate nearly 40-fold higher than that achieved using conventional methods. Using this system, it was also possible to introduce two constructs simultaneously into a single cell. The resulting stable transfectants, expressing tdTomato and enhanced green fluorescent protein, exhibited both red and green fluorescence. The established cell line did not lose the acquired phenotype over three months of culture. Based on our results, we concluded that PB is superior to currently available methods for introducing plasmid DNA into HDDPCs. There may be significant challenges in the direct clinical application of this method for human dental tissue engineering due to safety risks and ethical concerns. However, the high level of transfection achieved with PB may have significant advantages in basic scientific research for dental tissue engineering applications, such as functional studies of genes and proteins. Furthermore, it is a useful tool for the isolation of genetically engineered HDDPC-derived stem cells for studies in tooth regenerative medicine.
Cells, Cultured
;
DNA Transposable Elements
;
Dental Pulp
;
cytology
;
Humans
;
Induced Pluripotent Stem Cells
;
cytology
;
Nerve Tissue Proteins
;
genetics
;
Tooth, Deciduous
;
cytology
;
Transfection