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41.
Ryosuke Nakashima Masaaki Nishihara Takeshi Iyonaga Sho Iwasaka Yuzo Yamamoto Yuji Shono Jun Maki Kentaro Tokuda Tomohiko Akahoshi Taiki Higo Takanari Kitazono Hiroyuki Tsutsui 《Medicine》2021,100(23)
Rationale:In coronavirus disease 2019 (COVID-19) patients with acute respiratory distress syndrome refractory to optimal conventional management, we should consider the indication for veno-venous extracorporeal membrane oxygenation (V-V ECMO). Growing evidence indicates that COVID-19 frequently causes coagulopathy, presenting as hypercoagulation and incidental thrombosis. For these reasons, a multifactorial approach with several anticoagulant markers should be considered in the management of anticoagulation using heparin in COVID-19 patients on V-V ECMO.Patient concerns:A 48-year-old man was infected with COVID-19 with a worsening condition manifesting as acute respiratory distress syndrome.Diagnoses:He was refractory to conventional therapy, thus we decided to introduce V-V ECMO. We used heparin as an anticoagulant therapy for V-V ECMO and adjusted the doses of heparin by careful monitoring of the activated clotting time (ACT) and activated partial thromboplastin time (APTT) to avoid both hemorrhagic and thrombotic complications. We controlled the doses of heparin in the therapeutic ranges of ACT and APTT, but clinical hemorrhaging and profound elevation of coagulant marker became apparent.Interventions:Using thromboelastography (TEG; Haemonetics) in addition to ACT and APTT, we were able to clearly detect not only sufficient coagulability of COVID19 on V-V ECMO (citrated rapid thromboelastography-R 0.5 min, angle 75.5°, MA 64.0 mm, citrated functional fibrinogen-MA 20.7 mm) but also an excessive effect of heparin (citrated kaolin -R 42.7 min, citrated kaolin with heparinase 11.7 min).Outcomes:Given the TEG findings indicating an excessive heparin effect, the early withdrawal of ECMO was considered. After an evaluation of the patient''s respiratory capacity, withdrawal from V-V ECMO was achieved and then anticoagulation was stopped. The hemorrhagic complications and elevated thrombotic marker levels dramatically decreased.Lessons:TEG monitoring might be a useful option for managing anticoagulation in COVID-19 patients on V-V ECMO frequently showing a hypercoagulative state and requiring massive doses of heparin, to reduce both hemorrhagic and thrombotic complications. 相似文献
42.
Janssen R Sato H Grutters JC Ruven HJ du Bois RM Matsuura R Yamazaki M Kunimaru S Izumi T Welsh KI Nagai S van den Bosch JM 《American journal of respiratory and critical care medicine》2004,170(11):1185-1187
CC10 (CC16, uteroglobin) is a pulmonary protein postulated to play a counter regulatory role in sarcoidosis pathogenesis. The adenine38guanine (A38G) polymorphism of the encoding CC10 gene (SCGB1A1) is functional. Recently, an association between the low CC10 producing 38A allele and sarcoidosis susceptibility has been reported in Japanese patients from Hokkaido. The aim of the present study was to confirm this association in a clinically well characterized population of Dutch white and Kyoto Japanese patients with sarcoidosis and control subjects. No difference in genotype or allele frequency was found between patients with sarcoidosis and control subjects in either ethnic population. Remarkably, however, a significant difference was found between the control subjects from Kyoto and Hokkaido, but not between the Japanese groups of patients with sarcoidosis. Furthermore, review of previously published A38G genotyping results showed a consistent difference in CC10 A38G allele frequencies between whites and Japanese subjects. We conclude that the CC10 A38G polymorphism does not influence sarcoidosis susceptibility in Dutch whites or in Japanese subjects from Kyoto. This stresses the importance of studying the influence of polymorphisms on disease susceptibility in multiple ethnically and geographically distinct disease and control populations before reaching conclusions. 相似文献
43.
Nobushige Takahashi Hidetoshi Takahashi Osamu Takahashi Ryosuke Ushijima Rie Umebayashi Junji Nishikawa Yasutomo Okajima 《PM & R》2018,10(2):168-174
Background
Spasticity is a common sequela of upper motor neuron pathology, such as cerebrovascular diseases and cerebral palsy. Intervention for spasticity of the ankle plantarflexors in physical therapy may include tone-inhibiting casting and/or orthoses for the ankle and foot. However, the physiological mechanism of tone reduction by such orthoses remains unclarified.Objective
To investigate the electrophysiologic effects of tone-inhibiting insoles in stroke subjects with hemiparesis by measuring changes in reciprocal Ia inhibition (RI) in the ankle plantarflexor.Design
An interventional before–after study.Setting
Acute stroke unit or ambulatory rehabilitation clinic of a university hospital in Japan.Participants
Ten subjects (47-84 years) with hemiparesis and 10 healthy male control subjects (31-59 years) were recruited.Methods
RI of the spastic soleus in response to the electrical stimulation of the deep peroneal nerve was evaluated by stimulus-locked averaging of rectified electromyography (EMG) of the soleus while subjects were standing.Main Outcome Measurements
The magnitude of RI, defined as the ratio of the lowest to the baseline amplitude of the rectified EMG at approximately 40 milliseconds after stimulation, was measured while subjects were standing with and without the tone-inhibiting insole on the hemiparesis side.Results
Enhancement of EMG reduction with the tone-inhibiting insole was significant (P < .05) in the subjects with hemiparesis, whereas no significant changes were found in controls.Conclusion
Tone-inhibiting insoles enhanced RI of the soleus in subjects after stroke, which might enhance standing stability by reducing unfavorable ankle plantarflexion tone.Level of Evidence
III 相似文献44.
Ryosuke Ando Aya Tomita Kohei Watanabe Hiroshi Akima 《Clinical physiology and functional imaging》2018,38(4):566-572
We compared vasti muscle electromyograms for two knee joint angles during fatiguing tetanic contractions. Tetanic contraction of the knee extensors was evoked for 70 s by electrical stimulation of the femoral nerve at knee joint angles of 60° (extended, with 0° indicating full extension) and 110° (flexed) in eight healthy men. Surface electromyography was recorded from the vastus intermedius (VI), vastus lateralis (VL) and vastus medialis (VM) muscles. Knee extension force and M‐wave amplitudes and durations were calculated every 7 s, which were normalized by the initial value. Normalized knee extension force was decreased at the flexed knee joint angle compared with that of the extended knee joint angle (P<0·05). Decreased normalized M‐wave amplitude and increased normalized M‐wave duration of the VI were greater at the flexed knee joint angle than the extended knee joint angle (P<0·05), whereas those for the VL and VM were similar (P>0·05). These results suggest that peripheral fatigue profiles of the VI might be greater at the flexed than the extended knee joint angles, but that of VL and VM might be similar in the tested range of knee joint angles (i.e. 60°–110°) during continuous tetanic contraction induced by electrical stimulation. Therefore, greater reduction of knee extension force at the flexed knee joint angle than the extended knee joint angle may reflect fatigue development of the VI more than other quadriceps femoris components. 相似文献
45.
Ryosuke Arakawa Lars Farde Junya Matsumoto Naoki Kanegawa Igor Yakushev Kai-Chun Yang Akihiro Takano 《Molecular imaging and biology》2018,20(2):183-187
Purpose
Positron emission tomography (PET) in non-human primates (NHP) is commonly performed under anesthesia, with sevoflurane being a widely used inhaled anesthetic. PET measurement in NHP can be repeated, and a difference in radioligand kinetics has previously been observed between the first and second PET measurement on the same day using sevoflurane anesthesia. In this study, we evaluated the effect of prolonged sevoflurane anesthesia on kinetics and binding potential (BPND) of [11C]raclopride in NHP.Procedures
Three cynomolgus monkeys underwent two to three PET measurements with [11C]raclopride under continuous sevoflurane anesthesia on the same day. The concentration of sevoflurane was adjusted according to the general conditions and safety parameters of the NHP. Time to peak (TTP) radioactivity in the striatum was estimated from time-activity curves (TACs). The BPND in the striatum was calculated by the simplified reference tissue model using the cerebellum as reference region.Results
In each NHP, the TTP became shorter in the later PET measurements than in the first one. Across all measurements (n = 8), concentration of sevoflurane correlated with TTP (Spearman’s ρ = ? 0.79, p = 0.03), but not with BPND (ρ = ? 0.25, p = 0.55).Conclusions
These data suggest that sevoflurane affects the shape of TACs but has no evident effect on BPND in consecutive PET measurements.46.
Tahata Yuki Hikita Hayato Mochida Satoshi Enomoto Nobuyuki Kawada Norifumi Kurosaki Masayuki Ido Akio Miki Daiki Yoshiji Hitoshi Takikawa Yasuhiro Sakamori Ryotaro Hiasa Yoichi Nakao Kazuhiko Kato Naoya Ueno Yoshiyuki Yatsuhashi Hiroshi Itoh Yoshito Tateishi Ryosuke Suda Goki Takami Taro Nakamoto Yasunari Asahina Yasuhiro Matsuura Kentaro Yamashita Taro Kanto Tatsuya Akuta Norio Terai Shuji Shimizu Masahito Sobue Satoshi Miyaki Tomokatsu Moriuchi Akihiro Yamada Ryoko Kodama Takahiro Tatsumi Tomohide Yamada Tomomi Takehara Tetsuo 《Journal of gastroenterology》2022,57(2):120-132
Journal of Gastroenterology - Direct-acting antiviral (DAA) therapy enables a high rate of sustained virologic response (SVR) in patients with hepatitis C virus associated cirrhosis. However, the... 相似文献
47.
Nakatsuka Takuma Nakagawa Hayato Hayata Yuki Wake Taijiro Yamada Tomoharu Nishibatake Kinoshita Mizuki Nakagomi Ryo Sato Masaya Minami Tatsuya Uchino Koji Enooku Kenichiro Kudo Yotaro Tanaka Yasuo Kishikawa Takahiro Otsuka Motoyuki Tateishi Ryosuke Koike Kazuhiko 《Journal of gastroenterology》2021,56(5):456-469
Journal of Gastroenterology - Liquid biopsies, particularly those involving circulating tumor DNA (ctDNA), are rapidly emerging as a non-invasive alternative to tumor biopsies. However, clinical... 相似文献
48.
Hashimoto K Shimada M Suehiro T Soejima Y Minagawa R Hiroshige S Shiotani S Ninomiya M Harada N Komori K Sugimachi K 《Hepato-gastroenterology》2003,50(52):1146-1148
Portal vein thrombosis is a rare surgical complication following liver transplantation, which remains a cause of graft loss and death. We describe here the treatment of portal vein thrombosis following living donor liver transplantation using an extended left lobe graft. The patient was treated with a Gore-Tex vascular jump graft extra-anatomically interposed between the recipient superior mesenteric vein and the donor umbilical vein. This technique allowed the hepatic hilum to be left untouched and supplied suitable blood flow to the hepatic allograft. Our experience suggests that this innovative technical solution can be helpful in the effort to rescue cases of hepatic allograft with vascular complications. 相似文献
49.
Satoshi Seino Ryosuke Matsuoka Yasunobu Masuda Masaaki Kunou Yuka Okada 《Cutaneous and ocular toxicology》2020,39(1):13-20
AbstractPurpose: To evaluate the effects of topical hyaluronan (HA) on corneal epithelial wound healing when administered with or without benzalkonium chloride (BAC).Methods: A cultured human corneal epithelial cell line (HCE-T) was subjected to in vitro scratch assays and in situ epithelial migration was evaluated in organ-cultured rabbit corneas. The corneal epithelium of C57BL/6J mice was also evaluated to determine in vivo wound healing. An in vivo imaging system was also used to evaluate the effects of HA on eye drop retention on the ocular surface.Results: The findings revealed the promotion of HCE-T migration, in situ rabbit corneal epithelial migration, and in vivo wound healing in mouse corneal epithelium by HA. Pre-treatment with HA also protected against delayed epithelial wound healing in BAC in vitro. However, pre-treatment with 3?mg/mL HA did not show a protective effect against BAC in vivo, but instead delayed epithelial wound healing and increased detection of cleaved caspase-3. This suggested that HA promotes the retention of BAC on the ocular surface. The instilled HA was retained after 15?min, at a significantly higher rate than for phosphate-buffered saline.Conclusions: The combination of HA and BAC impaired wound healing in the corneal epithelium. 相似文献
50.
Yuichi Takata Ryosuke Fukaki Shinji Matsuoka Koji Iwamoto Shigenori Miyamoto Eiichi Uchiyama 《Journal of Physical Therapy Science》2021,33(7):517
[Purpose] The purpose of this study was to elucidate whether insoles alter postural sway on a sideward slope rather than on level ground. [Participants and Methods] This study involved 20 flat-footed individuals and 20 normal-footed individuals. The postural sway was determined based on the total length of the locus and the body sway area, which were measured using the Zebris system. The participants were divided into three groups: the BMZ insoles, Superfeet insoles, and no insole groups. These insoles were worn by the participants with their normal shoes worn daily. [Results] The total length of the locus of the BMZ group was significantly lower than those of the Superfeet and no-insole groups. The body sway area did not significantly differ based on the insole condition. [Conclusion] BMZ insoles improve postural sway in both normal-footed and flat-footed individuals on a sideward slope. 相似文献