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41.
Hiroshi Morita MD Douglas P. Zipes MD Shiho T. Morita MD Jiashin Wu PhD 《Heart rhythm》2007,4(1):66-74
BACKGROUND: The Brugada syndrome is characterized by ST-segment elevation on the ECG, especially in the right precordial leads sensitive to the right ventricular outflow tract (RVOT). OBJECTIVES: The purpose of this study was to evaluate the hypothesis that right ventricular electrophysiologic heterogeneity caused arrhythmogenicity in the Brugada syndrome. METHODS: Action potentials (APs) were mapped on the epicardium of 14 RVOT preparations and on the transmural surfaces of 15 pairs of RVOT and right ventricular anteroinferior (RVAI) preparations isolated from canine hearts. Brugada ECG and arrhythmias were induced with pilsicainide (2.5-12.5 micromol/L), pinacidil (1.25-12.5 micromol/L), and terfenadine (2.0 micromol/L). RESULTS: Low doses of drugs elevated the J-ST segment and induced APs with both short and long action potential durations (APDs) in contiguous RVOT epicardial regions. In addition, APs in the RVOT had a larger phase 1 notch and longer APD than in RVAI. The longest APDs were in the epicardium in RVOT but in the endocardium in RVAI regions. High doses of drugs eliminated the phase 2 dome of the AP and abbreviated APDs in the epicardium but not in endocardium and reduced the epicardial heterogeneity of APs but increased the transmural gradient of APD in 14 (93%) of the RVOT preparations. In contrast, abbreviations of epicardial APDs occurred in only 4 (27%) of the RVAI preparations. Ventricular tachycardia occurred more frequently in the RVOT (47%) than in paired RVAI preparations (7%). Blocking the transient outward current reduced the heterogeneity of APs and eliminated arrhythmogenicity in all preparations. CONCLUSION: Compared with the RVAI region, the RVOT has greater electrophysiologic heterogeneity that contributes to arrhythmogenicity in this model of Brugada syndrome. 相似文献
42.
Tetsuya Ozeki Shuji Beppu Takuto Mizoe Yuuki Takashima Hiroshi Yuasa Hiroaki Okada 《Journal of controlled release》2005,107(3):387-394
In this study, we used a novel 4-fluid nozzle spray drier to prepare composite microparticles of a water-insoluble drug, flurbiprofen (FP), and a water-soluble drug, sodium salicylate (SS), for the purpose of improving the water solubility of FP. An ethanol solution of FP and an aqueous SS solution were simultaneously introduced through different liquid passages in the 4-fluid nozzle spray drier and then spray-dried. Quantitative elemental analysis suggested that the FP/SS ratio in each composite microparticle was nearly the same as the formulation ratio. We also found that SS and FP exist in a low crystallinity state in the composite particles. Release of FP from dissolved composite microparticles was markedly improved because of an increase in the effective surface area following rapid dissolution of SS. This study shows that it is possible to prepare FP-SS composite microparticles using a 4-fluid nozzle spray drier in single process and that this can improve the ability of FP to dissolve in water. 相似文献
43.
44.
Yoshimasa Sakamoto Kazuhiro Hashimoto Hiroshi Okuyama Shinichi Ishii Takahiro Inoue Katsushi Kinouchi Takayuki Abe 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(9):465-469
Objective The objective of the present study was to compare long-term results of single aortic valve replacement (AVR) with mechanical
(St. Jude Medical valves: standard) and biologic (the Carpentier-Edwards pericardial) prostheses. Method: Between 1995 and 2002, 95 patients who underwent single AVR with mechanical (n=46) or biologic (n=49) prostheses were enrolled
in this study. The mean age at the operation was 54.0±9.6 years (range: 20 to 69 years) with the mechanical and 68.8±7.1 years
(range: 44 to 85 years) with the biologic prosthesis. Results: The 9-year actuarial survival rate, which was calculated by taking perioperative mortality into account, was 90.3±4.6% for
patients with mechanical valves and 87.6 ±4.8% for patients with bioprostheses, with no difference between the two groups
(p=0.342). The 9-year freedom rate from thromboembolism, reoperation, endocarditis was 94.8+3.6%, 100% and 97.8 ±2.2% for
patients with mechanical valves and 98.0 ±2.0%, 97.5 ±3.4% and 95.0 ±3.4% for those with bioprostheses, respectively. After
9 years, freedom from cardiac death averaged 97.8% in the group with mechanical valves compared with 95.3% in those with bioprostheses
(p=0.541). Conclusion: We conclude that the mid-term durability of the Carpentier-Edwards pericardial valve in the aortic position for the elderly
is excellent. Nevertheless, the risk of tissue valve reoperation progressively increases with time, and a longer follow-up
may be necessary to provide its value compared with the mechanical valves in a country like Japan with a high life expectancy.
(Jpn J Thorac Cardiovasc Surg 2005; 53:465-469) 相似文献
45.
Kazuaki Shimamoto Toru Kita Hiroshi Mabuchi Masunori Matsuzaki Yuji Matsuzawa Noriaki Nakaya Shinichi Oikawa Yasushi Saito Jun Sasaki Hiroshige Itakura 《Hypertension research》2007,30(2):119-123
Hyperlipidemia, hypertension, and diabetes mellitus (DM) are well-established risk factors for cardiovascular disease. We analyzed the cardiovascular events in hyperlipidemic patients with or without DM who were administered open-labeled simvastatin in groups stratified by blood pressure level using data from the Japan Lipid Intervention Trial (J-LIT). Hyperlipidemic patients with DM (n=6,288) had significantly more cardiovascular events than those without DM (n=33,933). The incidence rates of total cardiovascular events in the Non-DM and DM groups were 15.40 and 25.76 per 1,000 patients for the 6-year period, respectively. The relative risk of total cardiovascular events in the DM vs. the Non-DM group was 1.68, and the relative risk was significantly higher in the DM than in the Non-DM group. The relative risks of total cardiovascular events were significantly higher in DM and Non-DM patients whose systolic blood pressure (SBP) was greater than or equal to 130 mmHg compared to that of Non-DM patients whose SBP was less than 130 mmHg, and in DM and Non-DM patients whose diastolic blood pressure (DBP) was greater than or equal to 80 mmHg compared to that of Non-DM patients whose DBP was less than 80 mmHg. In all groups stratified by SBP and DBP, relative risks of total cardiovascular events were higher in DM patients than in Non-DM patients. For patients with hypercholesterolemia and DM, blood pressure should be strictly controlled in order to prevent both coronary events and stroke. These results are in good agreement with the JNC 7 and the ESH/ESC guidelines for DM patients, which recommended that the SBP and DBP be less than 130 and 80 mmHg, respectively. 相似文献
46.
Hiroshi Asanuma Hiroyuki Satoh Seiichiro Shishido 《International journal of urology》2007,14(1):43-47
OBJECTIVE: Tubularized incised plate urethroplasty has become a popular technique for repairing distal and proximal hypospadias in many institutions. Dorsal inlay graft urethroplasty has been used in our institution since 2003 to reduce the risk of meatal stenosis. In the present study, we evaluated the results of the dorsal inlay graft procedure. METHODS: A total of 28 patients with no deep groove and no severe curvature underwent one-stage urethroplasty using an inner preputial-based dorsal inlay graft. The medical records of all patients were retrospectively reviewed with regard to complication rate and cosmetic appearance. RESULTS: Mean patient age at surgery was 21 months (range, 14 months to 4.6 years). Preoperatively the urethral meatus was coronal in two cases, distal shaft in 17, proximal shaft in six and penoscrotal in three. Nine patients required testosterone therapy before surgery. Mean operative time was 200 min (range, 154-249 min). Mean length of inlay graft was 20.9 mm (range, 12-30 mm). In all patients, a straight penis was achieved without dorsal plication of the corposa cavernosa, and the neomeatus with a slit-like appearance was positioned at the glans tip. At a mean of 22 months of follow up, a urethrocutaneous fistula developed in only one patient (3.6%), requiring repair surgery 6 months after urethroplasty. No patient had meatal stenosis, neourethral stricture or urethral diverticulum along the inlay graft. CONCLUSION: Dorsal inlay graft urethroplasty is an effective method for hypospadiac repair and leads to good cosmetic outcome with low risk of complications. 相似文献
47.
Tadamasa Miyauchi Hiroshi Takiya Toshihiko Sawamura Eiji Murakami 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(4):206-209
Pericardial abscess is rare in healthy individuals, especially the amebic type. We report a case of pericardial abscess and
cardiac tamponade due to intrapericardial rupture of an amebic liver abscess. A 31-year old Japanese male complained of fever
to a local hospital. A liver mass was discovered in his left hepatic lobe by an abdominal echogram. He was referred to the
internal department of our hospital and was treated with quinolone antibiotics. Two weeks after medication, he suddenly complained
of epigastralgia and severe orthopnea and was admitted. Abdominal computed tomographic scan showed an enlarged liver mass,
and massive pericardial effusion suggested cardiac tamponade. He underwent an emergency subxiphoid partial pericardiectomy
under local anesthesia. 1,000 ml of light brownish fluid was removed and his condition improved. Although no ameba was cultivated
from the pus, the amebic serological test was positive. Metronidazole was administered and the patients was discharged 31
days after surgery. 相似文献
48.
Katsuyoshi Habiro Hiroaki Shimmura Sakiko Kobayashi Motoko Kotani Yasuo Ishida Kazunari Tanabe Hiroshi Toma Ryo Abe 《American journal of transplantation》2005,5(4):702-711
Previously, we reported that allogeneic skin grafts were rapidly rejected by CD28 and CD40 ligand double deficient mice mediated by CD8+ T cells. These results indicated that some elements in addition to CD28- and CD40-mediated costimulation provide stimulatory signals for the activation of donor-specific CD8+ T cells. In this report, we investigated the role of inflammation associated with transplantation on costimulation-independent priming of CD8+ T cell during graft rejection. B6 RAG1 KO mice were transplanted with BALB/c-skin and adoptively transferred with syngeneic CD8+ T cells the same day or 50 days after transplantation. When blockade of CD28- and CD40-mediated costimulation failed to prevent acute rejection of freshly transplanted skin grafts, it efficiently delayed rejection of well-healed skin grafts. These results showed that factors associated with transplantation have essential roles in inducing costimulation blockade-resistant allograft rejection. Costimulation blockade failed to prevent acute graft-infiltration of NK cells and increasing expression of intragraft IL-12 and IL-15. These factors may trigger the graft-infiltration and priming of CD8+ T cells to induce costimulation blockade-resistant allograft rejection. 相似文献
49.
Self-expandable metallic stent for unresectable malignant strictures in the esophagus and cardia 总被引:2,自引:0,他引:2
Shigeru Lee Harushi Osugi Taigo Tokuhara Masashi Takemura Masahiro Kaneko Yoshinori Tanaka Yushi Fujiwara Satoshi Nishizawa Hiroshi Iwasaki Shigefumi Suehiro 《The Japanese Journal of Thoracic and Cardiovascular Surgery》2005,53(9):470-476
Objective Self-expandable metallic stent (EMS) placement has been the first choice for dysphagia because of the certainty over its safety,
low invasiveness, and immediate efficacy. However, there still remain some problems in relation to the EMS placement site
and anticancer therapies before and after EMS placement. Methods: Consecutive 78 patients in whom EMS was placed due to the unresectable malignant stricture in the esophagus or cardia from
July 1995 to August 2003 in our department were studied. Results: Gastroesophageal reflux was found in 5 of 8 patients after placement of conventional EMS for the stricture in the gastroesophageal
junction. Meanwhile, acid and bile reflux into the esophagus were not detected by pH and bilirubin monitoring, respectively,
in 6 patients after placement of the EMS with an anti-reflux mechanism for the stricture in the gastroesophageal junction.
The median survival period of all patients after EMS placement was 123 days. The median survival period of 7 patients with
radiotherapy only after EMS placement was 138 days and that of 17 patients with radiotherapy before EMS placement was 60 days,
which was shorter than that of the former (p<0.05). On the other hand, the median survival period after hospital admission
due to dysphagia of these 7 patients was longer than that of 17 patients with radiotherapy only before EMS placement, although,
the difference was not significant. Conclusion: EMS with an antireflux mechanism is not commercially available in Japan and approval is urgently required. The indication
of radiotherapy associated with EMS placement is to be studied further. 相似文献
50.
Fumio Nakajima Tomohiko Asano Masamichi Hayakawa Hiroshi Nakamura 《International journal of urology》1996,3(1):s19-s21
We evaluated nitric oxide induction in antitumor therapy consisting of anti–CD3 monoclonal antibody (anti–CD3) and interleukin–2 (IL–2), then determined the effect of nitric oxide reduction with L–NG –monomethyl arginine (LNMA) on the therapeutic methods. Female C57BL/6 mice, MCA102 (a non immunogenic, NK–resistant murine fibrosarcoma cell line), and 145–2C11 (hamster anti–murine–CD3 mAb) were utilized in an experimental hepatic metastasis model developed by injecting a tumor cell suspension into the spleen of mice. A marked increase in serum NO2 – + NO1 was observed at 19 hours after anti–CD3 (10 μ, IV) and additional IL–2 administrations (40times101 U, twice, If) induced a further increase. The NO2 , + NO3- elevation in spot urine in the combination therapy was not suppressed with LNMA at a dose of 100 μg/h but was significantly lowered at 300 μg/h. The efficacy of the anti–CD3 + IL–2 therapy was not diminished by LNMA administration either at 100 μg/h or at 300 μg/h. 相似文献