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Miura Y.,Health Sciences University of Hokkaido | Kanazawa K.,Health Sciences University of Hokkaido | Nasu I.,Okitama Public General Hospital
Journal of Neurosurgical Anesthesiology | Year: 2015

We previously showed that preischemic administration of high-dose isoflurane worsened the outcome from severe forebrain ischemia in rats. Conversely, high doses of sevoflurane have been reported to improve the outcome from forebrain ischemia when the insult is moderate. To clarify the dose-dependent effects of sevoflurane on severe forebrain ischemia, we performed an outcome study using an identical protocol to that in our previous study with isoflurane. Fasting male Sprague-Dawley rats underwent surgical preparation for forebrain ischemia under halothane anesthesia. Anesthesia was changed to fentanyl/nitrous oxide to eliminate the halothane, after which 30 minutes of 0.5, 1.0, 1.5, 2.0, or 2.5 minimum alveolar concentration sevoflurane was administered. Ten minutes of ischemia was induced by bilateral carotid occlusion plus systemic hypotension, in which cessation of electroencephalographic activity was confirmed. Sevoflurane was discontinued and anesthesia continued with fentanyl/nitrous oxide for an additional 100 minutes. Outcome evaluation at 5 days postischemia included seizure incidence, mortality rate, neuromotor score, and histologic injuries to the cerebral cortex and hippocampal CA1 and CA3. Different doses of sevoflurane did not statistically affect seizure incidence (10.0% to 18.2%), mortality rate (20.0% to 46.7%), cortical damage (mild to moderate degree), or hippocampal CA1 damage (93.7% to 96.7% neuronal necrosis) or CA3 damage (36.3% to 41.7%). Dose-dependent effects of sevoflurane were not observed for any of the outcome variables assessed in this rat model of severe forebrain ischemia. © 2014 Wolters Kluwer Health, Inc.

Kameoka J.,Tohoku University | Takahashi N.,Akita University | Noji H.,Fukushima Medical University | Murai K.,Iwate Medical University | And 7 more authors.
International Journal of Hematology | Year: 2012

T-cell prolymphocytic leukemia (T-PLL) is characterized by a post-thymic immunophenotype, salient chromosome abnormalities, and an aggressive clinical course. However, cases in which these features are absent have been occasionally reported in Japan. Here, clinical and biological features of 13 T-PLL cases, diagnosed between 1992 and 2009 in the Tohoku region of Japan, were compared with three Western series. Median age was 64 (range 40-78) years old, and the male to female ratio (12:1) was higher than that of the Western series (P<0.04). Presented manifestations were similar to those of Western cases, but central nervous system involvement, which is rare in Western cases, was observed in 3 of 13 cases (23 %) (P<0.04). Immunophenotypic patterns were similar to those of Western cases, but HLA-DR was positive in 6 of 9 cases (67 %), which is distinct from Western cases (0-9 %) (P<0.002). By chromosome analyses, 14q11 abnormality and trisomy 8q, which are common among Western cases (70-80 %), were not observed in any cases (P<0.002). Morphologically, seven were classified as typical type, five as a small-cell variant, and one as a cerebriform variant. Seven cases experienced an aggressive course, whereas six experienced an indolent course over a median follow-up of 50 months. In contrast to Western cases, clinical courses were closely correlated with morphological types; 86 % of typical types were aggressive, whereas 83 % of small-cell types were indolent (P = 0.025). On the basis of these observations, together with previous Japanese cases in the literature, we propose that Japanese cases of T-PLL may constitute a variant. © The Japanese Society of Hematology 2012.

Yamada M.,Okitama Public General Hospital
Kyobu geka. The Japanese journal of thoracic surgery | Year: 2011

We report a rare case of metastatic brain and lymph node carcinoma of unknown primary origin. A 68-year-old man had been followed up after resection of brain metastasis in right parietooccipital region without suspicious primary site. Seventy-eight months after the resection, a mediastinal lymph node (#2R) of 15 mm in diameter was detected by computed tomography (CT) and was surgically removed. The histological diagnosis was poorly differentiated adenocarcinoma resembling lymphoepithelial carcinoma, which was similar to the histology of the previously resected brain tumor. This patient is alive without recurrence and apparent primary site at 24 months after lymph node resection.

Watanabe T.,Yamagata University | Miyamoto T.,Yamagata University | Miyasita T.,Yamagata University | Shishido T.,Yamagata University | And 10 more authors.
Journal of Cardiology | Year: 2014

Background and purpose: Many clinical trials have shown that 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors (statins) can significantly reduce coronary artery disease in both primary and secondary prevention. A recent study showed that aggressive lipid-lowering therapy with strong statins could achieve coronary artery plaque regression, as evaluated with gray-scale intravascular ultrasound (IVUS). However, it is unknown whether coronary plaque regression and stabilization are reinforced when eicosapentaenoic acid (EPA) is used with a strong statin. Methods and subjects: We aim to assess patients with stable angina or acute coronary syndrome who had undergone successful percutaneous coronary intervention (PCI) with integrated backscatter IVUS (IB-IVUS) guidance. They will be randomly allocated to receive pitavastatin (4. mg), or pitavastatin (4. mg) plus EPA (1800. mg), and prospectively followed for 6-8 months. Results: The primary endpoint will be changes in tissue characteristics in coronary plaques, evaluated by IB-IVUS, and secondary endpoints will include absolute changes in coronary plaque volume, serum lipid levels, and inflammatory markers. The safety profile will also be evaluated. Conclusions: The combination therapy of EPA and pitavastatin for regression of coronary plaque evaluated by IB-IVUS (CHERRY) study will be the first multicenter study using IB-IVUS to investigate the effects of combination therapy with pitavastatin and EPA on coronary plaque volume and tissue characteristics. © 2014 Published by Elsevier Ltd on behalf of Japanese College of Cardiology.

Furukawa T.,Yamagata University | Nagase T.,Yamagata Prefectual Shinjo Hospital | Shoji H.,Yamagata Prefectual Shinjo Hospital | Ogata S.,Yamagata Prefectual Central Hospital | Yakuwa S.,Okitama Public General Hospital
Practica Oto-Rhino-Laryngologica | Year: 2015

Cervical lymphangioma usually occurs in children as a soft tumor, but lymphangioma of the palatine tonsil is an extremely rare lesion that presents as a tonsillar outgrowth. We report herein on our rare experience with a 30 years old female patient with lymphangioma of the palatine tonsil. She presented with a foreign body sensation and a nonproductive cough from two years previously. Her tonsillar lymphangioma was treated by wide surgical excision with a tonsillectomy. Recurrence of tonsillar lymphangioma has not been detected to date at 8 months after surgery. We present herein the course of this case with several references to previous literature.

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