Stenting after thrombectomy with the AngioJet™ catheter for acute myocardial infarction

The presence of massive intracoronary thrombi may contraindicate stenting. The AngioJet™ catheter rheolytic thrombectomy prepared the road for an easy and uneventful stenting in 2 patients with acute myocardial infarction (AMI) and thrombi. This combination provides a promising strategy for patients with AMI and angiographic evidence of massive thrombi. Cathet. Cardiovasc. Diagn. 43:327–330, 1998. © 1998 Wiley-Liss, Inc.     

Numerical analysis of the proximal humeral outline: Bilateral shape differences

A new method is presented for the numerical analysis of bilateral differences in the size and shape of the proximal humeral outlines using elliptical Fourier functions (EFFs). A skeletal sample of 36 pairs of right and left humeri was used. The proximal superior view in the plane of the proximodistal axis of each humerus was photographed with an 800 mm telephoto lens. The two-dimensional humeral outlines were carefully traced onto acetate sheets and 54 boundary points were located. These points were digitized and used to compute size-standardized EFFs with 27 harmonics. From the EFFs, a set of expected points on the proximal humeral outline was generated using the centroid as an origin. Superimposition of the right and left humeral outlines on this centroid provided a detailed picture of the relative bilateral shape differences with respect to that center. The proximal humeri showed significant bilateral size and shape differences, although the pattern of asymmetry in shape varied with respect to the region on the boundary outline. In particular, one localized aspect, the tubercular region of the proximal humeri showed significant bilateral shape differences. In contrast, the humeral head consistently showed not only a much smaller degree of bilateral shape differences, but also much less variability in size as well as shape. The results suggest that while the overall articular shape changes little with altered mechanical loadings placed on articular surfaces, the changes in the tubercular regions of the proximal humeri may be susceptible to the varying stresses associated with particular physical activities. Am. J. Hum. Biol. 11:343–357, 1999. © 1999 Wiley-Liss, Inc.     

Exercise-induced ST-segment changes permit prediction of improvement in left ventricular ischemic dysfunction after revascularization: Evaluation with positron emission tomographic measurements of regional myocardial blood flow and cardiac output

Background  Prediction of the recovery of left ventricular (LV) ischemic dysfunction after revascularization is important in patients with coronary artery disease (CAD). We investigated whether the improvement in LV ischemic dysfunction after revascularization could be predicted preoperatively by exercise-induced ST-segment changes. Methods and Results  Regional myocardial blood flow (RMBF) and cardiac output were measured with nitrogen 13-ammonia positron emission tomography at rest and during low-level exercise in 28 patients with angiographically proven CAD before and after successful revascularization and in 9 normal subjects. Before revascularization, exercise-induced upsloping ST-segment depression <1 mm 80 msec after the J-point was observed in 11 patients (group 1), horizontal depression of 1 to 1.5 mm was observed in 0 patients (group 2), and downsloping depression ≥1.5 mm was observed in 8 patients (group 3). The number of regions of critical CAD was greater in group 3 than in groups 1 and 2 (3.6±1.4 vs 1.6±0.7 and 2.2±1.1, p<0.001, p<0.02). Increase of RMBF in regions of critical CAD with exercise was lower in group 3 than in groups 1 and 2 (0.15±0.01 vs 0.22±0.01 and 0.18±0.02 ml/min per gram, p<0.0001, p <0.01). After revascularization, RMBF in regions of critical CAD both at rest and during exercise improved in groups 1 (0.49±0.15 to 0.60±0.18, 0.70±0.26 to 0.86±0.33 ml/min per gram, both p<0.05) and 2 (0.50±0.15 to 0.62±0.19, 0.67±0.26 to 0.89±0.31 ml/min per gram, both p<0.02), but was unchanged in group 3 (0.47±0.09 to 0.47±0.15, 0.62±0.17 to 0.64±0.23 ml/min per gram, both p=NS). Cardiac output at rest improved in groups 1 (4.98±0.43 to 5.35±0.50 L/min, p<0.02) and 2 (5.08±0.52 to 5.53±0.28 L/min, p<0.02), but was unchanged in group 3 (4.76±0.48 to 4.88±0.82 L/min, p=NS). Conclusions  Our results suggest that marked downsloping ST-segment depression induced by preoperative low-level exercise may predict a lack of improvement in LV ischemic dysfunction after revascularization. Presented in part at the 69th Scientific Sessions of the American Heart Association, New Orleans, Louisiana, November 1996.     

Infection Prevention Mask Consisting of Nanofiber Filter and Habutae Silk Fabrics

To reduce skin irritation and allergic symptoms caused by long-term mask use, we produced a mask with a filter effect by laminating nanofibers on habutae silk fabric, a specialty of Japan’s Fukui Prefecture, using the electrospinning method. We investigated the filter characteristics of silk fabrics with different weave structures (habutae, flat crepe, and twill). We found that woven fabrics alone could not sufficiently block particles finer than 1 μm, even when the fabric layers were overlapped. Therefore, we had a nanofiber filter layer fabricated on the surface of habutae fabric by the electrospinning method at a weight of 1 g/m². The nanofibers removed more than 94% of 0.3 μm-particles, which are similar to the size of virus particles. However, the nanofiber layer was so dense that it caused an increase in pressure drop, so we made the nanofiber layer thinner and fabricated the filter on the surface of the habutae fabric at 0.5 g/m². A three-dimensional mask consisting of two woven fabrics, one with a nanofiber layer on the inside and the other with a normal woven fabric without a nanofiber layer on the outside, was fabricated and tested on 95 subjects. The subjects reported that the nanofiber habutae masks were more comfortable than nonwoven masks. Moreover, the silk woven masks did not cause allergic symptoms such as skin irritation.     

The prognosis and immunohistochemical evaluation of five perianal Paget's disease cases

Perianal Paget's disease is categorized as Paget's disease, which is epidermotropic neoplasm arising from the apocrine glands of perianal region, or Pagetoid spread invaded from rectal or anal canal cancer. It has been reported that the immunohistochemical staining of GCDFP15, the marker of the apocrine epithelium, and CK20 is used to be distinguished between Paget's disease and Pagetoid spread. Five patients with perianal Paget's disease who underwent a surgical operation had been treated in our department between 1997 and 2006. We analyzed the clinical findings and the treatment of these patients and investigated the expression of GCDFP15 and CK20 by immunohistochemical staining. All cases presented the redness around perianal regions, and 2 cases were recognized a tumor at the anal canal. We preoperatively diagnosed these cases as Pagetoid spread and others without tumor regions as Paget's disease. Surgical treatment was performed for all patients. As a result of immunohistochemical staining, 2 cases of Pagetoid spread were negative for GCDFP15, and positive for CK20. It was compatible with the preoperative diagnosis. Only one of 3 Paget's disease cases was positive for GCDFP15 and negative for CK20 resulting in the diagnosis of perianal Paget's disease. Based on the expression of negative for GCDFP15 and positive for CK20, others were seemed to be Pagetoid spread. A treatment strategy including surgical operation and chemotherapy is different between patients with Paget's disease and those with Pagetoid spread. Therefore, it is essential to investigate the expression pattern of GCDFP15 and CK20 using the tissue from the biopsy to identify the disease for appropriate treatment.     

Rapid detection of germline mutations for hereditary gastrointestinal polyposis/cancers using HaloPlex target enrichment and high-throughput sequencing technologies

Genetic testing for hereditary colorectal polyposis/cancers has become increasingly important. Therefore, the development of a timesaving diagnostic platform is indispensable for clinical practice. We designed and validated target enrichment sequencing for 20 genes implicated in familial gastrointestinal polyposis/cancers in 32 cases with previously confirmed mutations using the HaloPlex enrichment system and MiSeq. We demonstrated that HaloPlex captured the targeted regions with a high efficiency (99.66 % for covered target regions, and 99.998 % for breadth of coverage), and MiSeq achieved a high sequencing accuracy (98.6 % for the concordant rate with SNP arrays). Using this approach, we correctly identified 33/33 (100 %) confirmed alterations including SNV, small INDELs and large deletions, and insertions in APC, BMPR1A, EPCAM, MLH1, MSH2, MSH6, PMS2, and SKT11. Our approach yielded the sequences of 20 target genes in a single experiment, and correctly identified all previously known mutations. Our results indicate that our approach successfully detected a wide range of genetic variations in a short turnaround time and with a small sample size for the rapid screening of known causative gene mutations of inherited colon cancer, such as familial adenomatous polyposis, Lynch syndrome, Peutz–Jeghers syndrome, and Juvenile polyposis syndrome.