著者

Shunsuke Tamaki Yoshihiro Sato Takahisa Yamada Takashi Morita Yoshio Furukawa Yusuke Iwasaki Masato Kawasaki Atsushi Kikuchi Takumi Kondo Tatsuhisa Ozaki Masahiro Seo Iyo Ikeda Eiji Fukuhara Makoto Abe Jun Nakamura Masatake Fukunami

出版者

日本循環器学会

雑誌

Circulation Journal (ISSN:13469843)

巻号頁・発行日

pp.CJ-16-1122, (Released:2017-02-16)

参考文献数

39

被引用文献数

34

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Background:Although the mainstay of treatment for acute decompensated heart failure (ADHF) is decongestion by diuretic therapy, it is often associated with worsening renal function (WRF). The effect of tolvaptan, a selective V2 receptor antagonist, on WRF in ADHF patients with preserved left ventricular ejection fraction (LVEF) is unknown.Methods and Results:We enrolled 50 consecutive ADHF patients whose LVEF on admission was ≥45%. Patients were randomly assigned to either tolvaptan add-on (n=26) or conventional diuretic therapy (n=24). The primary endpoint was the incidence of WRF, defined as an increase in serum creatinine (Cr) ≥0.3 mg/dL or 50% above baseline within 48 h of randomization. There was no significant difference between the 2 groups in the change in body weight or the total urine volume during 48 h. However, the change in Cr (∆Cr) at 24 and 48 h after randomization and the incidence of WRF (12% vs. 42%, P=0.0236) were significantly lower, and the fractional excretion of urea (FEUN) at 24 and 48 h after randomization was significantly higher in the tolvaptan group. There was an inverse correlation between ∆Cr and FEUN at 48 h after randomization.Conclusions:Tolvaptan can alleviate congestion with a significantly lower risk of WRF in ADHF patients with preserved LVEF, presumably through maintenance of renal perfusion.

著者

Hirotaka Muraoka Takashi Kaneda Naohisa Hirahara Kotaro Ito Shunya Okada Takumi Kondo

出版者

Japanese Society for Magnetic Resonance in Medicine

雑誌

Magnetic Resonance in Medical Sciences (ISSN:13473182)

巻号頁・発行日

pp.mp.2021-0153, (Released:2022-03-11)

参考文献数

30

被引用文献数

1

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Purpose: Chronic diffuse sclerosing osteomyelitis (CDSO) is a non-suppurative inflammatory bone disease diagnosed based on combined clinical, histopathological, and radiological findings. Accurate diagnosis is important since CDSO is more refractory to treatment than suppurative osteomyelitis. The purpose of this study was to determine the diagnostic efficacy of diffusion-weighted imaging (DWI) in the quantitative assessment of CDSO to distinguish it from acute suppurative osteomyelitis (ASO) and chronic suppurative osteomyelitis (CSO) of the mandible.Methods: Using a retrospective cohort study design, we analyzed MRI data of 6 patients with CDSO and 34 patients with ASO and CSO. The mean apparent diffusion coefficient (ADC) values of the three groups (CDSO, ASO, and CSO groups) were calculated, and differences were analyzed using Kruskal–Wallis and post-hoc Mann–Whitney tests with Bonferroni adjustments. We performed a receiver operating characteristic (ROC) curve analysis to evaluate the ability of the ADC to predict CDSO. P < 0.05 was considered statistically significant.Results: The mean ADCs in the CDSO, ASO, and CSO groups were 1.22 ± 0.04 × 10–3 mm2/s, 1.28 ± 0.08 × 10–3 mm2/s, and 1.06 ± 0.09 × 10–3 mm2/s, respectively. Significant differences were observed between the ASO and CSO groups (P < 0.001) and CSO and CDSO groups (P < 0.01). However, there was no significant difference between the ASO and CDSO groups (P = 0.21). The ROC analysis revealed a cut-off ADC value of 1.19 for distinguishing the CSO group from the CDSO group. Sensitivity, specificity, accuracy, and area under the ROC curve were 1.0, 0.92, 0, 95, and 0.94, respectively.Conclusion: The results suggest that ADC may be useful in distinguishing CDSO from mandibular suppurative osteomyelitis.

著者

Yoshitsugu OHNUKI Takumi KONDO Hiroshi KUROSAWA

出版者

日本組織培養学会

雑誌

組織培養研究 (ISSN:09123636)

巻号頁・発行日

vol.36, no.2, pp.21-29, 2017 (Released:2017-05-24)

参考文献数

21

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Rho-associated protein kinase (ROCK) inhibitor, Y-27632, is an indispensable chemical molecule to maintain the viability of single-dissociated human induced pluripotent stem cells (hiPSCs) and to form cell aggregates in floating cultures. In this study, we investigated the effect of Y-27632 on the cardiac differentiation of the cell aggregates of hiPS cell line, 201B7. When Y-27632 was not added to the floating culture, the dissociated hiPSCs died and no cell aggregates were formed. The presence of greater than 10 μM Y-27632 was required to form spherical cell aggregates from the dissociated hiPSCs. However, Y-27632 used in the floating culture of the dissociated hiPSCs to form cell aggregates exhibited an inhibitory effect on cardiac differentiation in the adherent culture of cell aggregates. When 30 μM Y-27632 was added to the floating cultures, the extensibility of outgrowth from the cell aggregates was relatively lowered, and the initial time of contraction (the generation of beating cardiomyocytes) was markedly delayed in the adherent cultures. Moreover, the expression levels of the early cardiac differentiation-related genes of NKX2.5 and TNNT2 were decreased with increasing Y-27632 concentration. These results indicate that Y-27632 applied to the floating cultures for cell aggregate formation adversely affected the early cardiac differentiation in the following adherent cultures, although there was no influence on the final cardiac differentiation levels.