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Inoue K.,Japan National Cardiovascular Center Research Institute | Murakawa Y.,Teikyo University | Nogami A.,University of Tsukuba | Shoda M.,Tokyo Women's Medical University | And 6 more authors.
Journal of Cardiology | Year: 2016

Background and methods: The Japanese Heart Rhythm Society performs an annual survey, J-CARAF, to collect data on the atrial fibrillation (AF) ablation procedure, and requests its members to register data for AF ablation performed in specified months. We compared data from the latest survey (September 2013, n = 1049) with that of the previous survey (September 2012, n = 1246) to investigate trends related to the AF ablation procedure. Results: Patients in the latest survey were older (September 2012 vs. September 2013, 62.1 ± 10.7 years vs. 63.3 ± 10.8 years, p = 0.012), and fewer used antiarrhythmic drugs (73.3% vs. 67.4%, p < 0.0001). The fluoroscopic time decreased significantly (65.2 ± 47.2 min vs. 57.4 ± 38.8 min, p < 0.0001), although the frequency of left atrial linear ablation increased (21.5% vs. 28.2%, p = 0.0002). The use of factor Xa inhibitors (FXaI) during and post-procedure considerably increased (during, 3.0% vs. 15.8%; post, 3.7% vs. 32.8%, p < 0.0001), whereas warfarin and direct thrombin inhibitor (DTI) were used less as oral anticoagulants during or after the procedure (warfarin: during, 47.8% vs. 33.7%; after, 55.2% vs. 37.5%; DTI: during, 21.2% vs. 16.0%; after 38.4% vs. 28.3%; p < 0.0001). Conclusions: On comparison of the data from the surveys, the AF ablation procedure was observed to be performed in older patients and as a first-line therapy in Japan. In addition, more intensive ablation with less fluoroscopy was an observed trend. The use of FXaI during and after the procedure increased considerably, while the use of warfarin and DTI decreased. © 2016.


Inoue K.,Japan National Cardiovascular Center Research Institute | Murakawa Y.,Teikyo University | Nogami A.,Yokohama Rosai Hospital | Shoda M.,TokyoWomens Medical University | And 7 more authors.
Journal of Arrhythmia | Year: 2013

To assess the current status of atrial fibrillation (AF) ablation in Japan, the Japanese Heart Rhythm Society (JHRS) instituted a national registry, the Japanese Catheter Ablation Registry of AF (J-CARAF). Methods: Using an online questionnaire, the JHRS invited electrophysiology centers in Japan to voluntarily and retrospectively register data regarding the AF ablation procedures performed in September, 2011. Results: A total of 128 centers submitted data regarding AF ablation procedures in 932 patients (age 62.±10.4 years; male 76.8%; paroxysmal AF 65.7%, CHADS2 score 1.0±.0). The majority received oral anticoagulant therapy during and following the procedure (68.9% and 97.5%, respectively). Pulmonary vein isolation (PVI) was performed in 97.5% of the patients; ipsilateral encircling PVI was the preferred technique (79.7%). Three-dimensional (3D) mapping systems and irrigated-tip catheters were used in 94.8% and 87.7% of the procedures, respectively. Ablation methods other than PVI were performed in 78.8% of all the patients and 73.5% of the patients with paroxysmal AF. Acute complications were reported in 6.2% of the patients, but no early deaths were recorded. Conclusions: Ipsilateral encircling PVI, using 3D mapping and irrigated-tip catheters, is the standard AF ablation method in Japan. However, adjunctive ablations were performed frequently, even in patients with paroxysmal AF. © 2013 Japanese Heart Rhythm Society. Published by Elsevier B.V. All rights reserved.


PubMed | Tokyo Women's Medical University, University of Tsukuba, Jikei University School of Medicine, Fukuoka Sanno Hospital and 6 more.
Type: Journal Article | Journal: Journal of cardiology | Year: 2016

The Japanese Heart Rhythm Society performs an annual survey, J-CARAF, to collect data on the atrial fibrillation (AF) ablation procedure, and requests its members to register data for AF ablation performed in specified months. We compared data from the latest survey (September 2013, n=1049) with that of the previous survey (September 2012, n=1246) to investigate trends related to the AF ablation procedure.Patients in the latest survey were older (September 2012 vs. September 2013, 62.110.7 years vs. 63.310.8 years, p=0.012), and fewer used antiarrhythmic drugs (73.3% vs. 67.4%, p<0.0001). The fluoroscopic time decreased significantly (65.247.2min vs. 57.438.8min, p<0.0001), although the frequency of left atrial linear ablation increased (21.5% vs. 28.2%, p=0.0002). The use of factor Xa inhibitors (FXaI) during and post-procedure considerably increased (during, 3.0% vs. 15.8%; post, 3.7% vs. 32.8%, p<0.0001), whereas warfarin and direct thrombin inhibitor (DTI) were used less as oral anticoagulants during or after the procedure (warfarin: during, 47.8% vs. 33.7%; after, 55.2% vs. 37.5%; DTI: during, 21.2% vs. 16.0%; after 38.4% vs. 28.3%; p<0.0001).On comparison of the data from the surveys, the AF ablation procedure was observed to be performed in older patients and as a first-line therapy in Japan. In addition, more intensive ablation with less fluoroscopy was an observed trend. The use of FXaI during and after the procedure increased considerably, while the use of warfarin and DTI decreased.


Shigematsu H.,Tokyo Medical University | Yasuda K.,Hokkaido Chuo Rosai Hospital Spinal Cord Injury Center | Sasajima T.,Asahikawa University | Takano T.,Nihon Medical School | And 8 more authors.
International Angiology | Year: 2011

Aim. Hepatocyte growth factor is a potent angiogenic agent. This study investigated the efficacy and safety of intramuscular injection of naked plasmid DNA encoding the human hepatocyte growth factor gene in Japanese patients with Buerger's disease and critical limb ischemia. Methods. An open-label clinical study was performed at eight hospitals in Japan from May 2004 to April 2008. Ten patients were enrolled. They had Buerger's disease with ischemic ulcers, were not candidates for revascularization, and were unresponsive to conventional drug therapy. Treatment consisted of 8 injections (total dose: 4 mg) of hepatocyte growth factor plasmid, which were administered into the calf muscles and/or distal thigh muscles of the ischemic limbs under ultrasound guidance. Administration was done twice at an interval of 4 weeks. If there was no improvement after 2 doses, a 3rd dose could be administered. The response to treatment was evaluated from the reduction of ischemic ulcer size. Results. The size of ischemic ulcers showed a decrease in 6/9 (66.7%) patients and the ulcers healed completely in 5/9 (55.6%) patients after gene therapy. Major amputation was not required. There were no deaths and no major safety concerns. Conclusion. Hepatocyte growth factor gene therapy is safe and effective for critical limb ischemia in patients with Buerger's disease.


Yasuniwa Y.,University of Occupational and Environmental Health Japan | Yasuniwa Y.,Kyushu University | Izumi H.,University of Occupational and Environmental Health Japan | Wang K.-Y.,University of Occupational and Environmental Health Japan | And 17 more authors.
PLoS ONE | Year: 2010

Epidemiologic studies show a high incidence of cancer in shift workers, suggesting a possible relationship between circadian rhythms and tumorigenesis. However, the precise molecular mechanism played by circadian rhythms in tumor progression is not known. To identify the possible mechanisms underlying tumor progression related to circadian rhythms, we set up nude mouse xenograft models. HeLa cells were injected in nude mice and nude mice were moved to two different cases, one case is exposed to a 24-hour light cycle (L/L), the other is a more ''normal'' 12-hour light/dark cycle (L/D). We found a significant increase in tumor volume in the L/L group compared with the L/D group. In addition, tumor microvessels and stroma were strongly increased in L/L mice. Although there was a hypervascularization in L/L tumors, there was no associated increase in the production of vascular endothelial cell growth factor (VEGF). DNA microarray analysis showed enhanced expression of WNT10A, and our subsequent study revealed that WNT10A stimulates the growth of both microvascular endothelial cells and fibroblasts in tumors from light-stressed mice, along with marked increases in angio/ stromagenesis. Only the tumor stroma stained positive for WNT10A and WNT10A is also highly expressed in keloid dermal fibroblasts but not in normal dermal fibroblasts indicated that WNT10A may be a novel angio/stromagenic growth factor. These findings suggest that circadian disruption induces the progression of malignant tumors via a Wnt signaling pathway. Copyright: © 2010 Yasuniwa et al.


Kato K.,Kanagawa Childrens Medical Center | Tanaka M.,Kanagawa Childrens Medical Center | Toyoda Y.,Kanagawa Childrens Medical Center | Kigasawa H.,Kanagawa Childrens Medical Center | And 7 more authors.
Pathology Research and Practice | Year: 2013

Synovial sarcoma, which is difficult to diagnose precisely, is one of the most common childhood nonrhabdomyosarcoma soft-tissue sarcomas. The purpose of this study is to develop new molecular cytogenetic assay. We used two sets of two-color break-apart FISH probes, flanking either the SSX1/. SSX4 or SSX2 locus. Each set of probes is composed of differentially labeled DNA fragments complementary to sequences proximal or distal to the break point within the SSX1/. SSX4 or SSX2 locus, which are applied separately to histopathological sections. Interphase nuclei containing a translocation that disrupts either SSX1, SSX2, or SSX4 locus will display two single-color signals that have "broken apart" from each other. We applied it to two synovial sarcoma cell lines and clinical samples. This assay can detect translocation at either SSX1/. SSX4, or SSX2 locus on interphase spread prepared from synovial sarcoma cell line and histopathological sections, which is sufficient to diagnose as synovial sarcoma. Our new FISH assay has several advantages, including its applicability to paraffin-embedded samples, discrimination of the SS18- SSX1 and SS18- SSX2 translocations particularly in cases with aneuploidy, and potentially detecting translocations in all cases of synovial sarcoma, even with variant translocations. Our strategy will improve the accuracy of diagnoses, thereby facilitating appropriate treatment planning. © 2013 Elsevier GmbH.


Yamaguchi T.,Tokyo Dental College | Bissen-Miyajima H.,Keio University | Hori-Komai Y.,Tokyo Dental College | Matsumoto Y.,Tokyo Dental College | And 4 more authors.
Journal of Cataract and Refractive Surgery | Year: 2011

Purpose: To evaluate an outbreak of infectious keratitis after laser in situ keratomileusis (LASIK) at a single laser center in Japan. Setting: Tokyo Dental College, Chiba, Japan. Design: Case series. Methods: Relevant demographic and clinical data were obtained from case records using a standardized multicenter questionnaire at 12 major hospitals. The clinical manifestations, management, and outcomes were analyzed. Results: Thirty-nine eyes of 30 patients developed infectious keratitis after LASIK at the specified clinic. Cases of infection continued to appear over a 5-month period. The most common interval between LASIK and the onset of infection was within 2 weeks (36 eyes, 92.3%). Slitlamp manifestation included granular opacity beneath flap (71.8%), multiple infiltration (66.7%), and epithelial defect (30.8%). Mycobacterium was identified as the causative organism in 9 eyes (23.1%). In most cases, topical amikacin, arbekacin, and erythromycin in addition to fourth-generation fluoroquinolones were effective. Flap amputation was necessary in 10 eyes (25.6%) of 10 patients. Decimal visual acuity at initial presentation was worse than 0.10 in 14 eyes (35.9%), 0.15 to 0.50 in 8 eyes (20.5%), and 0.60 to 0.90 in 7 eyes (17.9%) and was better than 1.00 in 10 eyes (25.6%). Final decimal visual acuity was worse than 0.10 in 2 eyes (5.1%), 0.15 to 0.50 in 5 eyes (12.8%), and 0.60 to 0.90 in 11 eyes (28.2%) and was better than 1.00 in 21 eyes (53.8%). Conclusions: Mycobacterium was identified as the causative organism of this outbreak. This study shows the possibility of an epidemic of post-LASIK infectious keratitis. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. © 2011 ASCRS and ESCRS.

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