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21.
Yasuo Murai Takayuki Mizunari Ryo Takagi Yasuo Amano Sunao Mizumura Yuichi Komaba Seiji Okubo Shiro Kobayashi Akira Teramoto 《Clinical neurology and neurosurgery》2013
Background
Cerebral revascularization surgery (CRS) is increasingly recognized as an important component in the treatment of complex cerebral vascular disease and tumors. CRS requires that the incidence of perioperative neurological complications should be minimized, because CRS for ischemic disease is often not the goal of treatment, but rather a prophylactic surgery. CRS carries the risk of focal postoperative neurological deficits. Little has been established concerning mechanisms of post-CRS ischemia. We used 3.0-T diffusion-weighted magnetic resonance imaging (DWI) and magnetic resonance angiography (MRA) to analyze the incidence and mechanism of ischemic lesions.Methods
We studied the anterior circulation territory after 20 CRS procedures involving 33 vascular anastomosis procedures (13 double anastomoses and 7 single anastomoses) in 12 men and 8 women between June 2007 and October 2011. The operations included single or double superficial temporal artery–middle cerebral artery (STA–MCA) anastomosis to treat internal carotid artery/MCA occlusions or severe MCA stenosis. A combined STA–MCA anastomosis and indirect bypass were performed for moyamoya disease. Postoperative DWI and MRA were obtained in all patients between 24 and 96 h after surgery to detect thromboembolism, hypoperfusion, or procedural ischemic complications and vasospasms of the donor STA.Results
Follow-up DWI and MRA were carried out 1.8 ± 0.6 days after CRS (range, 1–4 days). Temporary occlusion time for anastomoses averaged 18.9 min (range, 16–32 min). Asymptomatic new hyperintensities occurred in the ipsilateral hemisphere of 2 patients on postoperative DWI (10% patients/6.0% anastomoses), and 1 moyamoya patient (5.0% patients/3.0% anastomoses) developed a symptomatic hyperintensity in the ipsilateral occipital lobe in response to the operation. Two abnormal small (<5 mm) cortical DWI lesions were caused by sacrifices of a small branch of the recipient MCA.Conclusion
This study is the first postoperative 3.0-T DWI study of CRS and related clinical events. The incidence of symptomatic postoperative DWI abnormalities was restricted to 1 moyamoya patient representing 5.0% of total patients and 3.0% anastomoses. Although some postoperative DWI abnormalities occurred, CRS was found to be safe with a low risk of symptomatic ischemia. 相似文献22.
23.
Yasuhiro Tsubokura Ryuichi Hasegawa Sunao Aso Toshio Kobayashi Takayuki Koga Satsuki Hoshuyama 《Drug and chemical toxicology》2018,41(4):492-500
We have conducted animal toxicity tests of chemicals for a chemical safety program implemented by the Ministry of Economy, Trade and Industry of Japan. Here we conducted a combined repeated-dose and reproductive/developmental toxicity screening test of benzene, 1,1′-oxybis-, tetrapropylene derivs. (BOTD). BOTD was administered to 9-week-old Crl:CD(SD) male and female rats by gavage at 0, 40, 200, or 1000?mg/kg/day. Males were treated for 42 days including mating period. Females were treated for 42–53 days through the premating, mating, pregnancy, and until Day 4 of lactation periods. Increases in prothrombin time and activated partial thromboplastin time values were observed only in males at 200 and 1000?mg/kg/day. Hypertrophy of centrilobular hepatocytes was observed with increased liver weight in both sexes at 200 and 1000?mg/kg/day, but there was no histologic evidence of hepatotoxicity. Diffuse hypertrophy of follicular cells in thyroid glands was observed in females at 200?mg/kg/day and in both sexes at 1000?mg/kg/day, with an increased blood cholesterol level in females at 1000?mg/kg/day. The conception index was decreased for females at 1000?mg/kg/day; and no abnormalities were detected in the reproductive indices of implantation, delivery, or pups’ condition, although a slight increase in the pups’ body weight was noted at birth. Our data indicate a no-observed-adverse-effect level of 40?mg/kg/day for repeated-dose toxicity on the basis of the prolongation of blood coagulating time, and of 200?mg/kg/day for reproductive/developmental toxicity on the basis of the decreased conception index. 相似文献
24.
25.
Akihiro Nakajima MD Makoto Araki MD PhD Osamu Kurihara MD PhD Yoshiyasu Minami MD PhD Tsunenari Soeda MD PhD Taishi Yonetsu MD Filippo Crea MD FACC Masamichi Takano MD PhD Takumi Higuma MD PhD Tsunekazu Kakuta MD PhD Tom Adriaenssens MD PhD Hang Lee PhD Sunao Nakamura MD PhD FACC Ik-Kyung Jang MD PhD FACC 《Catheterization and cardiovascular interventions》2021,97(4):634-645
26.
Sunao Kawano M.D. Nobuhiro Sato Shingo Tsuji Tatsuo Ogihara Hirohisa Tanimura Toshifumi Ito Masahiko Tsujii Nobuhiko Hayashi Hajime Sakura Takenobu Kamada 《Journal of gastroenterology》1989,24(1):1-7
The acute effect of cigarette smoking on the gastric mucosal blood volume index and the oxygen saturation of hemoglobin (SO2) in the gastric mucosa was investigated in 12 young male volunteers using reflectance spectrophotometry during endoscopy.
Six of these volunteers were habitual smokers who had smoked more than 20 cigarettes a day for more than five years. The others
were non-habitual smokers who smoked less than 20 cigarettes a year. The indices of mucosal blood volume and the mucosal blood
SO2 level were calculated from the spectra obtained at the lesser curvature of the lower corpus of the stomach before and after
cigarette smoking. The indices of mucosal blood volume and mucosal blood SO2 decreased significantly after one to three puffs of cigarette smoking in all subjects as compared to the value before smoking,
and the degree of decrease in these parameters was significantly greater in the non-habitual smokers than in the habitual
smokers. These results suggest that only one to three puffs of cigarette smoking causes a decrease in the mucosal blood volume
and the mucosal blood SO2 which might be related to weakening of mucosal defensive factors.
This work was supported by a grant from the Japan Tobacco Corporation. 相似文献
27.
Hiroyuki?Takahama Masanori?Asakura Yukio?Abe Masayoshi?Ajioka Kazutaka?Aonuma Toshihisa?Anzai Takaharu?Hayashi Shinya?Hiramitsu Hiroya?Kawai Hidetaka?Kioka Kazuo?Kimura Young-Jae?Lim Ken?Matsuoka Hirohiko?Motoki Yoji?Nagata Sunao?Nakamura Nobuyuki?Ohte Yukio?Ozaki Taishi?Sasaoka Shunsuke?Tamaki Toshimitsu?Hamasaki Masafumi?Kitakaze 《Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy》2018,32(4):381-388
Background
Previous studies suggest that the pathophysiology of heart failure with preserved ejection fraction (HFpEF) is characterized not only by high ventricular stiffness, but also by vascular stiffness. Azilsartan has higher vascular affinity compared with other angiotensin II receptor blockers (ARBs), which were proven to have no beneficial effects on clinical outcomes in patients with HFpEF in earlier clinical trials. We aimed to test the hypothesis that azilsartan may improve left ventricular diastolic function in HFpEF patients with hypertension in this trial.Methods
The Effects of Angiotensin Receptor Blockers on Diastolic Function in Patients Suffering from Heart Failure with Preserved Ejection Fraction: J-TASTE trial is a multicenter, randomized, open-labeled, and assessor(s)-blinded, active controlled using candesartan, parallel-group clinical trial, to compare changes in left ventricular (LV) diastolic dysfunction between HFpEF patients with hypertension who have received candesartan or azilsartan for 48 weeks. The primary endpoint is the change in early diastolic wave height/early diastolic mitral annulus velocity (E/e’) assessed by echocardiography from the baseline to the end of the study (48 weeks). A total of 190 patients will be recruited into the study.Conclusions
The design of the J-TASTE trial will provide data on whether differences between the effects of the two tested drugs on LV diastolic function exist in HFpEF patients with hypertension and will improve understanding of the pathophysiological role of vascular stiffness on diastolic function.28.
Sadayoshi Komori Soichi Sano Bing Hong Li Kuniyoshi Matsumura Akitaka Naitoh Sunao Mochizuki Tsukasa Ishihara Akinori Watanabe Ken Umetani Hiroshi Ijiri Keitaro Hashimoto Kohji Tamura 《Heart and vessels》1995,10(1):7-11
Summary We investigated the antiarrhythmic effects of bidisomide (SC-40230), a new class I antiarrhythmic drug, in early-phase ventricular arrhythmias induced by coronary artery occlusion and reperfusion in anesthetized rats. The effects of bidisomide were compared with those of mexiletine (MXT) and disopyramide (DSP), established class I antiarrhythmic drugs. Drugs were administered intravenously, 5 min before induction of coronary occlusion. Bidisomide (5 mg/kg) reduced the number of premature ventricular complexes and the incidence of ventricular tachycardia and ventricular fibrillation similarly to MXT and DSP in rats with ventricular arrhythmias induced by coronary artery occlusion. In rats with ventricular arrhythmias induced by coronary artery reperfusion following a 5min coronary occlusion, the antiarrhythmic effects of 5 mg/kg of bidisomide were similar to those of the same doses of MXT and DSP. All three drugs significantly slowed the heart rate. Our results suggest that bidisomide may effectively reduce the severity of lifethreatening ventricular arrhythmias that occur during acute coronary syndrome. 相似文献
29.
Naoko Takaoka Kenichi Tsujita Koichi Kaikita Seiji Hokimoto Michio Mizobe Masahide Nagano Eiji Horio Koji Sato Naoki Nakayama Hiromi Yoshimura Kenshi Yamanaga Naohiro Komura Sunao Kojima Shinji Tayama Sunao Nakamura Hisao Ogawa 《International journal of cardiology》2014
Background
Some plaques lead to ST-segment elevation myocardial infarction (STEMI), whereas others cause non-ST-segment elevation acute coronary syndrome (NSTEACS). We used angiography and intravascular ultrasound (IVUS) to investigate the difference of culprit lesion morphologies in ACS.Methods
Consecutive 158 ACS patients whose culprit lesions were imaged by preintervention IVUS were enrolled (STEMI = 81; NSTEACS = 77). IVUS and angiographic findings of the culprit lesions, and clinical characteristics were compared between the groups.Results
There were no significant differences in patients' characteristics except for lower rate of statin use in patients with STEMI (20% vs 44%, p = 0.001). Although angiographic complex culprit morphology (Ambrose classification) and thrombus were more common in STEMI than in NSTEACS (84% vs 62%, p = 0.002; 51% vs 5%, p < 0.0001, respectively), SYNTAX score was lower in STEMI (8.6 ± 5.4 vs 11.5 ± 7.1, p = 0.01). In patients with STEMI, culprit echogenicity was more hypoechoic (64% vs 40%, p = 0.01), and the incidence of plaque rupture, attenuation and “microcalcification” were significantly higher (56% vs 17%, p < 0.0001; 85% vs 69%, p = 0.01; 77% vs 61%, p = 0.04, respectively). Furthermore, the maximum area of ruptured cavity, echolucent zone and arc of microcalcification were significantly greater in STEMI compared with NSTEACS (1.80 ± 0.99 mm2 vs 1.13 ± 0.86 mm2, p = 0.006; 1.52 ± 0.74 mm2 vs 1.21 ± 0.81 mm2, p = 0.004; 99.9 ± 54.6° vs 77.4 ± 51.2°, p = 0.01, respectively). Quantitative IVUS analysis showed that vessel and plaque area were significantly larger at minimum lumen area site (16.6 ± 5.4 mm2 vs 14.2 ± 5.5 mm2, p = 0.003; 13.9 ± 5.1 mm2 vs 11.6 ± 5.2 mm2, p = 0.003, respectively).Conclusion
Morphological feature (outward vessel remodeling, plaque buildup and IVUS vulnerability of culprit lesions) might relate to clinical presentation in patients with ACS. 相似文献30.
Naoko Takaoka Kenichi Tsujita Koichi Kaikita Seiji Hokimoto Kenshi Yamanaga Naohiro Komura Tadasuke Chitose Takamichi Ono Michio Mizobe Eiji Horio Koji Sato Naoki Nakayama Michiyo Saito Satomi Iwashita Sunao Kojima Shinji Tayama Seigo Sugiyama Sunao Nakamura Hisao Ogawa 《Heart and vessels》2014,29(5):584-595
Despite current standards of care aimed at achieving targets for low-density lipoprotein cholesterol (LDL-C), many patients remain at high residual risk of cardiovascular events. We sought to assess the LDL-C-dependent differences in culprit intravascular ultrasound (IVUS) morphologies and clinical characteristics in patients with acute coronary syndrome (ACS). Eighty-six consecutive ACS patients whose culprit lesions imaged by preintervention IVUS were divided into two groups based on the fasting LDL-C level on admission: a low-LDL-C group (LDL-C <2.6 mmol/l, n = 45) and a high-LDL-C group (LDL-C ≥2.6 mmol/l, n = 41). Patients with stable angina with LDL-C <2.6 mmol/l (n = 30) were also enrolled as an age- and gender-matched control. The low-LDL-C ACS group was significantly older (72 ± 12 vs 64 ± 14 years, P = 0.007) and more diabetic (47 % vs 15 %, P = 0.001). Importantly, IVUS morphologies were comparable between low- and high-LDL-C ACS groups (all P not significant), whereas culprit plaque was more hypoechoic and less calcified in the low-LDL-C ACS group than in the low-LDL-C stable angina group. Furthermore, compared with the low-LDL-C ACS nondiabetic group, the low-LDL-C ACS diabetic group was more obese, more triglyceride rich (1.3 ± 0.6 vs 0.9 ± 0.4 mmol/l, P = 0.003), and more endothelially injured, but no different for the culprit IVUS morphologies. In multivariate analysis, diabetes was independently associated with a low LDL-C level on admission in patients with ACS. There was no relationship between the LDL-C level at onset and culprit-plaque IVUS morphologies in ACS patients, although culprit plaque in the low-LDL-C ACS group was more vulnerable than in the low-LDL-C stable angina group. In patients with low-LDL-C levels, diabetes with atherogenic dyslipidemia might be the key residual risk. 相似文献