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Iida A.,RIKEN | Hosono N.,RIKEN | Sano M.,Chibanishi General Hospital | Kamei T.,Chigasaki Tokushukai General Hospital | And 6 more authors.
Neurobiology of Aging | Year: 2012

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease characterized by selective motor neuron death in the brain and spinal cord. Many disease genes for ALS have been identified; however, each disease gene is responsible for very small fractions of ALS. Recently, mutations of the gene encoding optineurin (. OPTN) are reported in familial and sporadic ALS. . OPTN is also responsible for a small number of ALS, 3.8% of familial and 0.29% of sporadic ALS in Japanese. The low prevalence may be an underestimation due to incomplete screening of the mutation. To examine . OPTN mutations more extensively, we screened the . OPTN deletions using a quantitative PCR system. We examined 710 Japanese ALS subjects who had previously been found to have no . OPTN mutations by a screening using a PCR-direct sequence strategy. We identified 3 kinds of deletions in 5 patients; one was homozygous, and the remaining were heterozygous. All deletions occurred due to the Alu-mediated recombination and are expected to result in null alleles. Our results suggest that the . OPTN deletion mutation in ALS is not infrequent and the prevalence of the . OPTN mutation in Japanese sporadic ALS is considerably high. © 2012 Elsevier Inc..


Iida A.,RIKEN | Kamei T.,Chigasaki Tokushukai General Hospital | Sano M.,Chibanishi General Hospital | Oshima S.,Chiba Tokushukai Hospital | And 4 more authors.
Neurobiology of Aging | Year: 2012

Mutations in TARDBP encoding TDP (TAR DNA binding protein)-43 have been reported in familial and sporadic amyotrophic lateral sclerosis (ALS), but mostly in Caucasians. In other ethnic groups, four types of mutations are found in familial ALS. In sporadic ALS, the TARDBP mutations frequency is low in Caucasians (0-5%) and no mutation has been found in other ethnic groups. To examine spectrum of TARDBP mutations and its frequency in Japanese, we screened the TARDBP mutation in 721 Japanese ALS by direct sequencing. We identified a novel mutation, c.1069G > A (p.Gly357Ser) and a known mutation in sporadic ALS. One patient was homozygous for p.Gly357Ser, which was the first for TARDBP mutation. Our study showed that TARDBP mutations also occur in non-Caucasian sporadic ALS. The estimated frequency of the TARDBP mutation in sporadic ALS is 0.29% in Japanese. The mutation frequency in familial ALS in Japanese is also similar to that in Caucasian, and is ~10 times higher than that in Japanese sporadic ALS. © 2012 Elsevier Inc.


PubMed | National Center for Global Health and Medicine, Tokyo Metropolitan Tama Medical Center, University of Tokyo, Tokyo Teishin Hospital and 4 more.
Type: Journal Article | Journal: World journal of urology | Year: 2016

Small cell carcinoma of the urinary bladder (SCCB) is known for its aggressive clinical features and poor prognosis. No prognostic factor has been established so far. The aim of this study was to assess the significance of possible prognostic factors, including serum neuron-specific enolase (NSE), an established biomarker for small cell lung carcinoma.We retrospectively reviewed 31 patients with primary SCCB treated at our eight affiliate institutions between 2001 and 2014. The association of various clinicopathological factors at diagnosis, including the serum NSE value, with cancer-specific survival (CSS) was assessed. The log-rank test and Cox proportional hazards model were used for univariate and multivariate analyses, respectively.Nineteen (61.3%) died of SCCB during the follow-up, with a median survival time of 12.7months. Prognostic factors were analyzed for the 25 patients after excluding six with missing data. Univariate analysis demonstrated that stage (extensive disease) and serum NSE 25ng/ml were significantly associated with worse CSS. Multivariate analysis identified increased serum NSE value as a sole independent predictor of CSS (hazard ratio 18.52, p=0.0022).Serum NSE value at diagnosis was an independent prognostic factor for primary SCCB and may serve as a useful biomarker in the management of SCCB.


PubMed | Tokyo Women's Medical University, Kamagaya General Hospital and Chibanishi General Hospital
Type: Journal Article | Journal: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie | Year: 2016

This study aims to clarify the effect of intra-articular platelet-rich plasma (PRP) in total knee arthroplasty (TKA) in preventing postoperative bleeding.There were 315 knees that underwent TKA and were included in this study. The subjects were randomized by paramedical staffs. These were divided into the PRP group who received intra-articular PRP intraoperatively (n=109) and the control group who did not (n=206). We measured postoperative blood loss (drain bag volume), estimated blood loss, and change in hemoglobin (Hb) value at postoperative day 1, 2, 4, and 7. The clinical data were compared between the PRP group and the control group.The mean postoperative blood loss of 446.9149.7mL in the PRP group was significantly less than that in the control group (550.7178.1mL, p<0.001). The mean postoperative estimated blood loss of 437.5221.3mL in the PRP group was significantly less than that in the control group (552.2336.3mL, p<0.01). The mean change in Hb value (mg/dL) from baseline was -1.45 in the PRP group and -1.85 in the control group at postoperative 1day (p<0.05), -1.74 in the PRP group and -2.11 in the control group at postoperative day 2 (p<0.05), -2.30 in the PRP group and -2.47 in the control group at postoperative day 4 (p<0.05), and -1.98 in the PRP group and -2.46 in the control group at postoperative day 7 (p<0.01).In this prospective randomized study, those that received PRP after TKA had significantly less postoperative blood loss and change in Hb level. PRP appears to be effective in reducing postoperative bleeding in TKA.


PubMed | Tokyo Women's Medical University, Kamagaya General Hospital and Chibanishi General Hospital
Type: Journal Article | Journal: Journal of orthopaedics | Year: 2016

The objective of this study was to perform a hip structure analysis (HSA) of teriparatide (TPTD) treatment in women with postmenopausal osteoporosis.The study included 96 patients with postmenopausal osteoporosis and received 20g TPTD daily. HSA was performed by dual-energy X-ray absorptiometry.The percent changes from baseline for the cross-sectional moment of inertia, section modulus, buckling ratio, and femoral strength index based on HSA results were 9.8% (p<0.01), 10.7%, 3.3%, and 14.9% (p<0.01), respectively, at 24 months.Based on the HSA results obtained with DXA, TPTD was effective for hip structures.


Murakami T.,Osaka City University | Kawatani Y.,Chibanishi General Hospital | Nakamura Y.,Chibanishi General Hospital | Hori T.,Chibanishi General Hospital
Annals of Vascular Surgery | Year: 2015

We report a case of a 68-year-old man with a large saccular aneurysm (70 mm) of the aortic arch. Although abundant atherosclerotic plaques or mural thrombi are generally considered to be a contraindication for endovascular repair, the patient's multiple comorbidities and anatomic limitations with a patent internal thoracic artery graft adjacent to the aneurysm made him unfit for open repair. Transapical deployment of the endograft through the less-diseased ascending aorta, with a concomitant chimney graft and carotid-carotid bypass, was performed, without evident stroke or embolism. © 2015 Elsevier Inc.


Sano M.,Chibanishi General Hospital
Nihon rinsho. Japanese journal of clinical medicine | Year: 2013

Ezetimibe is a unique inhibitor of intestinal cholesterol absorption. Ezetimibe selectively inhibits intestinal cholesterol absorption by blocking Niemann-Pick C1-like 1 (NPCIL1). Ezetimibe accelerates VLDL and TG degradation. Therefore, ezetimibe ameliorates postprandial hyperlipidemia. Ezetimibe inhibited the progression of nonalcoholic fatty liver disease (NAFLD) by correcting insulin resistance and decreasing small dense LDL-C in human subjects. In clinical study, ezetimibe administration combined with statin failed to inhibit progression of IMT thickness in ENHANCE (Ezetimibe and Simvastatin in Hypercholesterolemia Enhances Atherosclerosis Regression) study. In this study baseline IMT thickness (0.7 mm) of patients was within normal range. Therefore only two years observation was too short to demonstrate anti-atherogenic effects of ezetimibe. SEAS(Simvastatin and Ezetimibe in Aortic Stenosis) trial examined effects of combination therapy with ezetimibe and statin in patients with aortic stenosis. Combination therapy could not inhibit progression of aortic stenosis. However, events of ischemic heart disease, especially CABG were significantly decreased only in combination group. Statin was not reported to reduce CVD(cardiovascular disease) in moderate to severe CKD patients. In SHARP(Study of Heart and Renal Protection) study, patients with severe renal disease were allocated either for statin alone group or combination therapy group with statin and ezetimibe. Combination therapy significantly decreased non-hemorrhagic stroke by 25 % compared with statin alone group in severe CKD and HD(hemodialysis) patients. Ezetimibe has unique lipid lowering profile increasing HDL-C concomitant with decreasing LDL-C and TG. Ezetimibe should be initiated first in patients with insulin resistant metabolic syndrome. Ezetimibe should be combined with statin to reduce not only LDL-C but RLP-C(remnant like lipoprotein particle choletserol) in type IIb dyslipidemia.


Nakamura Y.,Chibanishi General Hospital | Kawatani Y.,Chibanishi General Hospital | Ito Y.,Chibanishi General Hospital | Hori T.,Chibanishi General Hospital
Interactive Cardiovascular and Thoracic Surgery | Year: 2016

Standard treatment for mycotic aneurysm of thoracic aorta is complete debridement with replacement of the aneurysm with a homograft or Dacron graft. However, contamination from surrounding tissues may occur after the graft replacement. Transposition of the viable, well-vascularized tissues should be used to fill surrounding dead space and isolate the graft to prevent reinfection. Although the omentum is regarded as the best tissue, it is not always available for use. We describe here a new alternative technique for such situations, that is, the use of a pericardial fat flap for patients with a mycotic descending thoracic aortic aneurysm. © 2016 The Author 2016. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.


Inoue T.,Chibanishi General Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2014

Between December 2009 and August 2011, 120 patients with uncomplicated Stanford type B acute aortic dissection( UBAD) received medical treatment. In October 2010, we initiated an early rehabilitation program for UBAD patients in an acute phase. This early rehabilitation program, which was aimed at enabling the patient to walk around the ward within 2 days, was conducted for 87 consecutive patients;the remaining 33 were subjected to the conventional rehabilitation program. Mortality was not significantly different between the 2 groups. The incidence of atelectasis, need for mechanical ventilation, and intensive care unit syndrome during medical treatment occurred in 48% (16/33), 15% ( 5/33), and 30% ( 10/33), respectively, of the conventional group and in 3.4% ( 3/87), 1.1% (1/87), and 3.4% ( 3/87), respectively, of the early rehabilitation group. The outer diameter of the aorta was dilated after 4 weeks' rehabilitation in smaller percentage of patients in the early rehabilitation group than the conventional one. Thus, the early rehabilitation program was more effective for patients with UBAD than the conventional one.


Kanamori T.,Chibanishi General Hospital | Ichihara T.,Chibanishi General Hospital | Sakaguchi H.,Chibanishi General Hospital | Inoue T.,Chibanishi General Hospital
General Thoracic and Cardiovascular Surgery | Year: 2013

Objective: For the repair of acute type A aortic dissection (AADA), the optimal site of arterial cannulation remains controversial. We herein describe and investigate a technique for direct true lumen cannulation in patients with AADA. Methods: Between January 2011 and April 2012, 176 consecutive patients underwent emergency surgery for repair of AADA using the direct true lumen cannulation. Using this method, following temporary circulatory arrest, the dissected ascending aortic wall is incised transversely and the true lumen is identified. An aortic cannula is inserted into the true lumen directly, and the ascending aorta is snared tightly. Results: The manipulation was performed within 30 s in all patients. There were no technical problems with this method. The mean operative time, cardiopulmonary bypass time, cross-clamp time, and the circulatory arrest time were 241 ± 79, 158 ± 85, 123 ± 97 and 58 ± 39 min, respectively. There were no permanent neurological disorders following surgery. Seven patients (4.0 %) experienced temporary neurological disorders. Twenty-four patients (14 %) died in the hospital from several complications unrelated to technical problems of direct true lumen cannulation. Conclusions: Antegrade perfusion can be established safely and easily using the direct true lumen cannulation, which may be a promising standard arterial cannulation technique for the repair of AADA. © 2013 The Japanese Association for Thoracic Surgery.

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