Nozaki Tokushukai Hospital


Nozaki Tokushukai Hospital

Time filter
Source Type

We report on a case of a 23-year-old male with Wolff-Parkinson-White syndrome. At baseline, constant right atrial pacing induced antidromic atrioventricular reentrant tachycardia (AVRT), whereas constant right ventricular (RV) pacing only revealed a normal His-Purkinje system. Mapping below the mitral annulus during sinus rhythm revealed fusion of atrial and ventricular potentials at multiple lateral sites. After unsuccessful ablation at these sites, constant RV pacing induced a long RP interval, orthodromic AVRT with the earliest atrial site being located at an anterior aspect, where successful ablation was later achieved. These phenomena may indicate an unexpected arrhythmogenic effect of initial ablations. © 2011, Japanese Heart Rhythm Society. All rights reserved.

Kubo T.,Cardiovascular Research Foundation | Maehara A.,Cardiovascular Research Foundation | Mintz G.S.,Cardiovascular Research Foundation | Garcia-Garcia H.M.,Erasmus Medical Center | And 12 more authors.
American Heart Journal | Year: 2010

Background: Animal models show impairment of arterial healing after drug-eluting stents (DES) compared with bare-metal stents (BMS). Virtual histology intravascular ultrasound (VH-IVUS) offers an opportunity to assess lesion morphology in vivo. Methods: We used VH-IVUS in 80 patients to assess long-term (median = 10 months) native artery vascular responses after 76 implantations of DES compared with 32 BMS. The presence of "necrotic core abutting the lumen" was evaluated at baseline and follow-up. Results: At baseline, necrotic core abutting the lumen through the stent struts was observed in 76% of DES and 75% of BMS. Although the percentage of necrotic core within the plaque behind the stents did not change during follow-up in DES (23% [18%, 28%] to 22% [17%, 27%], P = .57) or BMS (22% [19%, 27%] to 20% [12%, 26%], P = .29), necrotic core abutting the lumen through the stent struts decreased more in BMS (75% to 19%, P < .001) than DES (76% to 61%, P = .036) because of the lack of an overlying, protective neointima in DES-treated lesions. Furthermore, within the adjacent reference segments, the incidence of necrotic core abutting the lumen decreased in BMS-treated lesions (proximal 23% to 0%, P = .023; distal 21% to 0%, P = .023), but not in DES (proximal 22% to 17%, P = .48; distal 23% to 21%, P = .82). Conclusions: Serial VH-IVUS analysis of DES-treated lesions showed a greater frequency of unstable lesion morphometry at follow-up compared with BMS. The apparent mechanism was a suppression of the protective neointimal hyperplasia layer coupled with a lack of vulnerable plaque resolution at reference segments in DES compared with BMS. © 2010 Mosby, Inc. All rights reserved.

Kishida K.,Osaka University | Hiuge-Shimizu A.,Osaka University | Funahashi T.,Osaka University | Okutsu M.,Nozaki Tokushukai Hospital | And 13 more authors.
Journal of Atherosclerosis and Thrombosis | Year: 2012

Aim: Multiple risk factor syndrome is a target for the prevention of coronary artery disease (CAD). A cluster of multiple risk factors, such as hypertension, glucose intolerance, and/or dyslipidemia, is encountered in Japanese without and with excess visceral fat. The present study investigated the relationship between multiple risk factor accumulation and CAD in Japanese without and with visceral fat accumulation. Methods: The study subjects comprised 257 Japanese with suspected CAD (males/females=153/ 104), who underwent 64-row multislice computed tomography (CT) coronary angiography and visceral fat area (VFA) measurement by CT. Based on the Japanese criteria for visceral fat accumulation, they were divided into those with VFA < 100 and ≥100 cm2. Results: In subjects with VFA < 100 cm2, the age- and sex-adjusted odds ratios (ORs) for 2 and 3 risk factors were 5.33 (95% confidence intervals; 1.04-27.38, p=0.0449) and 4.07 (0.72-23.15, p=0.1138), respectively, compared with VFA < 100 cm2 and 0 risk factor set at 1.0 (p=0.0569 for trend). In contrast, the respective ORs for subjects with VFA ≥100 cm2 were much higher [6.46 (1.25-33.44, p=0.0261) and 20.42 (3.60-115.73, p=0.0007)] (p<0.0001 for trend). The multivariate adjusted model demonstrated a significant relative excess CAD risk of 1.08 (p=0.0484) and 5.01 (p < 0.0001) for the interactions of 2 risk factors and VFA ≥100 cm2, and 3 risk factors and VFA ≥100 cm2, whereas multiple risk factor accumulation was not related with the increase of CAD risk in subjects with VFA < 100 cm2. Conclusions: Coexistence of visceral fat and risk factor accumulations is strongly associated with CAD in Japanese.

Hazama S.,Yamaguchi University | Shavkat A.,Nozaki Tokushukai Hospital | Oba K.,Hokkaido University | Sakamoto J.,Tokai Central Hospital | And 6 more authors.
Molecular Diagnosis and Therapy | Year: 2014

Background and Objectives: Uridine-diphosphate glucuronosyltransferase 1A (UGT1A) is a key enzyme involved in irinotecan metabolism, and polymorphisms in the UGT1A gene are associated with irinotecan-induced toxicity. The aim of this study was to elucidate the allele frequencies of UGT1A polymorphisms in healthy Uzbek volunteers, and to compare them with those of the Japanese population. Method: A total of 97 healthy volunteers from Uzbekistan were enrolled and blood samples were collected from each participant. Genotyping analysis was performed by fragment size analysis for UGT1A1*28, direct sequencing for UGT1A7*3 and UGT1A9*22, and TaqMan assays for UGT1A1*93, UGT1A1*6, UGT1A1*27, UGT1A1*60, and UGT1A7*12. The frequencies of polymorphisms were compared with the Japanese population by using the data previously reported from our study group. Results: When the Uzbek and Japanese populations were compared, heterozygotes or homozygotes for UGT1A1*28, UGT1A1*60, and UGT1A1*93 were significantly more frequent in the Uzbek population (P < 0.01). The rate of UGT1A7*12 was not significantly different between the two populations, whereas UGT1A1*6 and UGT1A9*22 were significantly less frequent in the Uzbek population (P < 0.05). UGT1A7*1 were less prevalent in the Uzbek population than in the Japanese population (P < 0.01). Conclusion: The Uzbek population has different frequencies of polymorphisms in UGT1A genes compared with the Japanese population. A comprehensive study of the influence of UGT1A1 polymorphisms on the risk of irinotecan-induced toxicity is necessary for optimal use of irinotecan treatment. © 2014 The Author(s).

Nishi S.,Sapporo Higashi Tokushukai Hospital | Nakayama Y.,Japan National Cardiovascular Center Research Institute | Ishibashi-Ueda H.,Japan National Cardiovascular Center Research Institute | Yoshida M.,Nozaki Tokushukai Hospital | Yonetani H.,Sapporo Higashi Tokushukai Hospital
Journal of Biomaterials Applications | Year: 2014

Objective: We sought to determine the patency of normal arterial branches from the covered segments of an artery after stenting. Background: Most intracranial aneurysms occur at arterial branching points (bifurcations, side-branches, or perforators). The post-stenting patency of normal arterial branches from the covered segments of the artery is important. We have previously developed a hybrid stent with micropores to prevent early parent artery occlusion by more early endothelialization, and mid- to long-term parent artery stenosis by control of intimal hyperplasia after aneurysm occlusion. Methods: We created aneurysms in 10 rabbits by distal ligation and intraluminal incubation of elastase within an endovascularly trapped proximal segment of the common carotid artery. All animals were treated with hybrid stents having micropores. Four animals were observed for one month and three each for three and 12 months. The patency of the side-branches of the subclavian artery was evaluated angiographically and in some cases, histologically. Results: Aneurysms were completely occluded at all time points other than 12 months. The subclavian artery and brachiocephalic artery were patent, without significant stenosis. All the side-branches of the subclavian artery detected on the preoperative angiogram remained patent at the final assessment. Conclusion: The use of hybrid stents for aneurysm repair and side-branch patency seems to be effective, as per the long-term results obtained in an animal model. © 2013 The Author(s).

Shogo N.,Sapporo Higashi Tokushukai Hospital | Yasuhide N.,Japan National Cardiovascular Center Research Institute | Hatsue I.-U.,Japan National Cardiovascular Center Research Institute | Yoshida M.,Nozaki Tokushukai Hospital
Clinical Neurology and Neurosurgery | Year: 2014

Purpose The treatment of large or giant cerebral aneurysms by surgical and/or endovascular techniques is difficult and poses relatively high risks. Therefore, a microporous self-expanding (hybrid) stent graft composed of a thin, expandable, segmented polyurethane (SPU) membrane with micropores and a drug-delivery system was developed. Materials and methods A commercially available, self-expanding carotid stent was covered with a thin microporous SPU membrane fabricated by the dip-coating method and the excimer laser ablation technique, with an intraluminal coating of argatroban. Experimentally fabricated lateral-wall aneurysms in canine carotid arteries using venous pouches were occluded with the hybrid stent graft (bale-shaped pore density of 23.6%) on one side and a bare-metal stent on the other side without systemic antiplatelet therapy. Results Angiography at 1, 6, and 12 months of stenting revealed that all arteries were patent without marked stenosis without systemic antiplatelet therapy. All aneurysms treated with hybrid stent grafts remained occluded throughout the 12-month period, while among those treated by bare-metal stents, 2 of 3 aneurysms were occluded at 6 months (67%) and only 1 of 3 aneurysms were occluded at 12 months (33%). Histology revealed that the novel hybrid stent graft had less intimal hyperplasia than the bare-metal stent. The hybrid stent graft was useful for the successful occlusion of these canine carotid aneurysms, even at 12 months. Conclusions The novel hybrid stent grafts are expected to overcome the disadvantages of fully covered stent grafts and simple bare-metal stents, while combining both their merits, and appear to be useful in the treatment of large or giant cerebral aneurysms. © 2014 Elsevier B.V.

Nishi S.,Sapporo Higashi Tokushukai Hospital | Nishi S.,Japan National Cardiovascular Center Research Institute | Nakayama Y.,Japan National Cardiovascular Center Research Institute | Ishibashi-Ueda H.,Japan National Cardiovascular Center Research Institute | And 2 more authors.
Journal of Artificial Organs | Year: 2011

Treatment of large (diameter 12-25 mm) or giant (diameter >25 mm) cerebral aneurysms with a broad neck in the cranio-cervical area is difficult and carries relatively high risks, even with surgical and/or endovascular methods. To this end, we have been developing a high-performance, self-expanding stent graft which consists of a commercially available NiTi stent (diameter 5 mm, length 20 mm) initially covered with a thin microporous segmented polyurethane membrane fabricated by the dip-coating method. Micropores are then created by the excimer laser ablation technique, and the outer surface is coated with argatroban. There are 2 types of micropore patterns: circular-shaped pore type (pore: diameter 100 μm, opening ratio 12.6%) and the bale-shaped pore type (pore: size 100 × 268 μm, opening ratio 23.6%). This self-expanding stent graft was tested on side-wall aneurysms of both canine carotid arteries that were experimentally induced using the venous pouches from the external jugular veins, with the self-expanding stent graft on one side and a bare self-expanding stent on the other side. All carotid arteries were patent and free of marked stenosis after 1 month. All aneurysms were occluded by stent grafts, while patent in those treated with bare stents. Histologically, the stent grafts with bale-shaped micropores and a high opening ratio were associated with less intimal hyperplasia (187 ± 98 μm) than the bare stents (341 ± 146 μm) or the stent grafts with circular micropores and a low opening ratio (441 ± 129 μm). A pore ratio of 23.6% was found to control intimal growth. © 2011 The Japanese Society for Artificial Organs.

Iwakiri R.,Saga Medical School | Higuchi K.,Osaka Medical College | Kato M.,Hokkaido University | Fujishiro M.,University of Tokyo | And 12 more authors.
Alimentary Pharmacology and Therapeutics | Year: 2014

Background Few studies have evaluated the effects of rabeprazole on low-dose aspirin (LDA)-induced gastroduodenal injuries.Aim To conduct a randomised, double-blind, triple-dummy, active-controlled, multicentre trial, named the PLANETARIUM study, to assess the efficacy, dose-response relationship and safety of rabeprazole for peptic ulcer recurrence in Japanese patients on long-term LDA therapy.Methods Eligible patients had a history of endoscopically confirmed peptic ulcers and were receiving long-term LDA (81 or 100 mg/day) therapy for cardiovascular or cerebrovascular protection. Subjects were randomly segregated into three groups receiving rabeprazole 10 mg once daily (standard dose in Japan), rabeprazole 5 mg once daily, or teprenone (geranylgeranylacetone; mucosal protective agent commercially available in Japan) 50 mg three times per day as an active control. The primary endpoint was recurrence of peptic ulcers over 24 weeks.Results Among 472 randomised subjects, 452 subjects (n = 151, 150, 151, respectively) constituted the full analysis set. The cumulative recurrence rates of peptic ulcers over 24 weeks in the 10- and 5-mg rabeprazole groups were 1.4% and 2.8%, respectively, both of which were significantly lower than that in the teprenone group (21.7%). The cumulative occurrence rate of bleeding ulcers over 24 weeks in the teprenone group was 4.6%, while bleeding ulcers were not observed in the 10- or 5-mg rabeprazole groups. Rabeprazole was well tolerated at both doses.Conclusion Rabeprazole prevents the recurrence of peptic ulcers with no evidence of a major dose-response effect in subjects on low-dose aspirin therapy. © 2014 John Wiley & Sons Ltd.

Nishimura Y.,Kyushu University | Hyuga S.,Kitasato University | Takiguchi S.,Institute for Clinical Research | Hyuga M.,Japan National Institute of Health Sciences | And 3 more authors.
International Journal of Oncology | Year: 2016

The MET tyrosine kinase receptor and its ligand, hepatocyte growth factor (HGF), are known to be overexpressed in a variety of malignant tumor cells, and are implicated in the development of gefitinib-resistance in human non-small cell lung cancer (NSCLC) cells. Ephedrae herba was previously reported to prevent HGF-induced cancer cell motility by directly suppressing HGF/MET signaling through the inhibition of MET tyrosine kinase, and treatment with its extract also considerably reduced MET protein levels. To further investigate the mechanism underlying the Ephedrae herba-induced inhibition of MET phosphorylation as well as its degradation and subsequent disappearance, we examined the effect of Ephedrae herba on HGF-stimulated MET endocytosis and downregulation via early/late endocytic pathways in an NSCLC cell line. Using immunofluorescence microscopy, we found that pretreatment of cells with Ephedrae herba extract dramatically changed the intracellular distribution of plasma membrane-associated MET, and that the resultant MET staining was distributed throughout the cytoplasm. Pretreatment of the cells with Ephedrae herba extract also led to the rapid loss of MET and phosphorylated (p)-MET in HGF-stimulated cells. In contrast, inefficient endocytic delivery of MET and p-MET from early to late endosomes was observed in the absence of Ephedrae herba extract, since considerable amounts of the internalized MET accumulated in the early endosomes and were not delivered to lysosomes up to 1 h after HGF-stimulation. Furthermore, large amounts of MET and p-MET that had accumulated in late endosomes of Ephedrae herba-pretreated cells after HGF stimulation were observed along with bafilomycin A1. Therefore, we inferred that degradation of MET occurred in the late endosome/ lysosome pathway. Moreover, western blot analysis revealed the accelerated degradation of MET and p-MET proceeds in cells pretreated with Ephedrae herba extract. Collectively, our results suggest that some components of Ephedrae herba have a novel role in promoting HGF-stimulated MET and p-MET endocytosis followed by its downregulation, likely mediated by the early/late endocytic pathways.

Ogata N.,Tokai University | Ikari Y.,Tokai University | Nanasato M.,Red Cross | Okutsu M.,Nozaki Tokushukai Hospital | And 4 more authors.
Cardiovascular Intervention and Therapeutics | Year: 2014

Maximum allowable contrast dose (MACD) calculated as body weight × 5/serum creatinine has been a standard contrast dye volume (CV) used to decrease contrast-induced acute kidney injury. Recent advances in intravascular ultrasound-guided percutaneous coronary intervention (PCI) can dramatically minimize CV. The safe threshold when using an extremely low-dose CV is unknown. This study was designed as a multicenter, retrospective study of chronic kidney disease (CKD) patients with estimated glomerular filtration rate (eGFR) <30 ml/min/1.73 m2 undergoing elective PCI. We divided the patients into three groups according to following criteria: (1) low dose, CV/eGFR ratio <1.0; (2) medium dose, CV/eGFR ratio ≥1 and

Loading Nozaki Tokushukai Hospital collaborators
Loading Nozaki Tokushukai Hospital collaborators