Publications by authors named "Satoru Murata"

146 Publications

New technique for false lumen coiling of spontaneous isolated superior mesenteric artery dissection.

CVIR Endovasc 2021 Apr 7;4(1):35. Epub 2021 Apr 7.

Department of Radiology, Nippon Medical School, 1-1-5 Sendagi,Bunkyo-ku, Tokyo, 113-8603, Japan.

Background: Spontaneous isolated visceral artery dissection is rarely encountered. Endovascular intervention with good outcomes has become popular for patients with persistent symptoms or developing ischemia. We could perform life-saving treatment for a spontaneous isolated superior mesenteric artery dissection with a unique endovascular intervention.

Case Presentation: We describe the case of an 80-year-old man who presented with acute abdominal pain and a spontaneous isolated superior mesenteric artery dissection measuring 35 mm in major diameter and 6.6 mm in minor diameter on abdominal contrast-enhanced computed tomography. After admission, abdominal pain was progressive, and a repeated scan revealed progression of the dissection. As an endovascular intervention, via the bilateral femoral approach, detachable coils were placed in the false lumen of the superior mesenteric artery dissection through the false lumen under the micro-balloon occlusion at the point of re-entry and entry through the true lumen to prevent coil migration. Technical and clinical success was achieved without serious adverse events.

Conclusion: Coil embolization using micro-balloon assistance combined with the double-catheter technique for a large entry and re-entry false lumen of a spontaneous isolated superior mesenteric artery dissection was useful and feasible.
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http://dx.doi.org/10.1186/s42155-021-00225-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8026782PMC
April 2021

A comparison of outcomes based on vessel type (Native artery vs. bypass graft) and artery location (Below-knee artery vs. non-below-knee artery) using a combination of multiple endovascular techniques for acute lower limb ischemia.

Ann Vasc Surg 2021 Apr 2. Epub 2021 Apr 2.

Department of Radiology, Nippon Medical School Hospital, Bunkyo, Tokyo, Japan.

Background: To evaluate outcomes of endovascular treatment (EVT) using a combination of multiple endovascular techniques for acute lower limb ischemia (ALLI) and to compare outcomes based on vessel type and artery location.

Methods: A total of 95 consecutive patients with ALLI (mean age, 72.0 years; 65 males; 104 lower limbs) who received emergency EVT using a combination of multiple endovascular techniques including thrombolysis, aspiration thrombectomy, stenting, and balloon angioplasty with or without surgical thromboembolectomy, between January 2005 and December 2017 were included. Vessel type was classified into native artery occlusion (native occlusion) and bypass graft occlusion (graft occlusion), including prosthetic and vein graft. Additionally, native arteries were categorized into below-knee occlusion and non-below-knee occlusion. Technical success, perioperative death (POD), ALLI-related death, amputation, amputation-free survival (AFS), and complications were compared according to vessel type (native occlusion vs. graft occlusion) and artery location (below-knee occlusion vs. non-below-knee occlusion).

Results: Of all patients with ALLI, 16.8% underwent a single endovascular technique, whereas 83.2% underwent a combination of multiple endovascular techniques. The technicalsuccess, POD, and ALLI-related death rates in the total number of patients were 94.7%, 11.6%, and 4.2%, respectively. A total of 67 patients (75 limbs) and 28 patients (29 limbs) were classified as having native occlusion and graft occlusion (prosthetic, 24 limbs; vein, 5 limbs), respectively. No significant differences in technical success (native occlusion: 92.5% vs. graft occlusion: 100%), POD (14.9% vs. 3.6%), and ALLI-related death (6.0% vs. 0%) were noted between native occlusion and graft occlusion. However, the 30-day AFS rate of native occlusion was significantly lower than that of graft occlusion (75.2% vs. 96.3%, P=0.01). The amputation rate (P=0.03) and AFS rate (P=0.03) of below-knee occlusion were significantly worse for below-knee occlusion patients than for non-below-knee occlusion patients.

Conclusions: EVT using multiple endovascular techniques for ALLI is effective and safe. A combination of multiple endovascular techniques is crucial for successful treatment. However, native occlusion may have a lower AFS rate than graft occlusion, and below-knee occlusion may have a higher risk of amputation than non-below-knee occlusion.
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http://dx.doi.org/10.1016/j.avsg.2021.02.023DOI Listing
April 2021

Late clinical outcomes of manual aspiration thrombectomy for a massive acute pulmonary thromboembolism.

Jpn J Radiol 2021 Mar 12;39(3):293-295. Epub 2020 Oct 12.

Department of Radiology, Teikyo University School of Medicine, Tokyo, Japan.

Purpose: We investigated the late outcomes of patients who underwent manual aspiration thrombectomy for acute massive pulmonary thromboembolism.

Materials And Methods: Fifteen patients underwent manual aspiration thrombectomy between December 1995 and June 2002. All patients were discharged after the procedure. Patients' statuses were checked by medical record examinations and telephone interviews. The median follow-up was 162 months (116-208 months).

Results: Five patients died during follow-up; two for malignancy, one for septic shock, one for cerebral infarction, and in one patient the cause of death was unknown. There were no pulmonary thromboembolism-related deaths during the period and no recurrence. The 1-year survival rate was 100%, the 5-year survival rate was 75.0 ± 12.5%, and the 10-year survival rate was 75.0 ± 12.5%.

Conclusion: Patients who undergo manual aspiration thrombectomy for acute massive pulmonary thromboembolism show acceptable outcomes.
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http://dx.doi.org/10.1007/s11604-020-01054-9DOI Listing
March 2021

Case of primary anorectal malignant melanoma treated with adjuvant immunotherapy.

J Dermatol 2020 Dec 12;47(12):e435-e436. Epub 2020 Sep 12.

Department of Dermatology, Jichi Medical University, Shimotsuke, Japan.

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http://dx.doi.org/10.1111/1346-8138.15585DOI Listing
December 2020

The Efficacy and Safety of Highly-Bioavailable Curcumin for Treating Knee Osteoarthritis: A 6-Month Open-Labeled Prospective Study.

Clin Med Insights Arthritis Musculoskelet Disord 2020 12;13:1179544120948471. Epub 2020 Aug 12.

Department of Orthopedic Surgery, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan.

Background: We previously developed a surface-controlled water-dispersible form of curcumin that we called Theracurmin. The area under the blood concentration-time curve (AUC) of Theracurmin in humans was 27-fold higher than that of curcumin powder. Previously, we reported on the anti-inflammatory effects of Theracurmin for knee osteoarthritis.

Hypothesis/purpose: We determined the clinical effects of orally administered Theracurmin in patients with knee osteoarthritis over a 6-month period.

Study Design: Open prospective study.

Methods: Fifty patients Kellgren-Lawrence grade II, III, or IV knee osteoarthritis who were above 40 years old were enrolled in this clinical study. Theracurmin containing 180 mg/day of curcumin was administered orally every day for 6 months. To monitor for adverse events, blood biochemistry analyses were performed before and after 6 months of each intervention. The patients' knee symptoms were evaluated at 0, 1, 2, 3, 4, 5, and 6 months based on the Japanese Knee Osteoarthritis Measure, the knee pain visual analog scale, and the knee scoring system of the Japanese Orthopedic Association.

Results: Five cases dropped out during the study, but no cases dropped out because of major problems. No major side effects were observed with Theracurmin treatment, including the blood biochemistry analysis results. The effective group included 34 cases (75.6%), while the not-effective group included 11 cases.

Conclusion: This study demonstrates the safety and good efficacy of Theracurmin for various types of knee osteoarthritis. Theracurmin shows great potential for the treatment of human knee osteoarthritis.
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http://dx.doi.org/10.1177/1179544120948471DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425263PMC
August 2020

Balloon-assisted Transcatheter arterial embolization using N-butyl cyanoacrylate for iatrogenic arterial bleeding by groin puncture: a new technology.

CVIR Endovasc 2020 Aug 23;3(1):42. Epub 2020 Aug 23.

Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.

Background: Balloon-assisted transcatheter arterial embolization (TAE) using n-butyl cyanoacrylate (NBCA) and lipiodol (Lp) mixture is a new endovascular treatment technique for iatrogenic arterial bleeding by groin puncture. It is less invasive compared to surgical repair, and NBCA migration into the circulation can be prevented by temporary balloon occlusion of the parent artery without ultrasound-guidance. This study aimed to report on the technical aspects and evaluate the efficacy and safety of fluoroscopically guided balloon-assisted transcatheter arterial embolization using NBCA for iatrogenic arterial bleeding by groin puncture.

Materials And Methods: The study included five patients (mean age 54.6 years; 3 male and 2 female) with iatrogenic arterial bleeding by groin puncture. We performed transcatheter arterial embolization using NBCA while occluding the responsible artery with a balloon catheter during the embolization to prevent NBCA migration. Two sheaths were inserted into the common femoral artery. A microcatheter was advanced into the pseudoaneurysm or extravasation via the contralateral sheath. A balloon catheter was advanced into the responsible artery until the balloon portion covered the leakage site via another sheath. After balloon inflation, the NBCA and Lip mixture was slowly injected until the pseudoaneurysm, or the extravasation was filled without touching the balloon. The microcatheter was removed immediately after the filling. We assessed technical success, overall success, and complications.

Results: The injured arteries were the external iliac artery (n = 1), the common femoral artery (n = 2), and the proximal portion of the superficial femoral artery (n = 2). NBCA was injected once in four cases and twice in one case where complete hemostasis could not be achieved with one injection. The technical and overall success rate was 100% with no complications, including distal embolization of NBCA.

Conclusions: Balloon-assisted TAE using NBCA is a feasible, effective, and safe treatment for iatrogenic arterial bleeding by groin puncture. It may also be applicable in other arterial bleeding situations where the potential risk of distal embolization can be decreased by applying the balloon-assisted technique.
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http://dx.doi.org/10.1186/s42155-020-00132-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443418PMC
August 2020

Case of lichen planus pemphigoides after pembrolizumab therapy for advanced urothelial carcinoma.

J Dermatol 2020 Sep 8;47(9):e321-e322. Epub 2020 Jun 8.

Departments of, Department of, Dermatology, Jichi Medical University, Shimotsuke, Japan.

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http://dx.doi.org/10.1111/1346-8138.15461DOI Listing
September 2020

Pulmonary valve replacement after tetralogy of Fallot repair in a patient with immune thrombocytopenia.

J Card Surg 2020 Jul 22;35(7):1711-1713. Epub 2020 May 22.

Department of Cardiovascular Surgery, Keio University School of Medicine, Tokyo, Japan.

Marked thrombocytopenia causes significant bleeding in cardiovascular surgery. Herein, we describe the case of a 47-year-old woman with immune thrombocytopenia who underwent successful pulmonary valve replacement for pulmonary valve regurgitation and stenosis after complete repair of tetralogy of Fallot. Her platelet count decreased significantly to less than 5 × 10 /L on postoperative day 3, thus multiple platelet transfusions were given. Pulse steroid therapy with dexamethasone was subsequently administered systemically for 4 days. After the treatment, her platelet count started to recover. There were no significant postoperative bleeding events, and red blood cell transfusion was not required. Other than the platelet event, the postoperative course was uneventful and the patient was discharged on postoperative day 15.
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http://dx.doi.org/10.1111/jocs.14640DOI Listing
July 2020

Diagnostic Clues for Pagetoid Bowen's Disease.

Indian J Dermatol 2020 Mar-Apr;65(2):167-169

Department of Dermatology, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan. E-mail:

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http://dx.doi.org/10.4103/ijd.IJD_362_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7059465PMC
March 2020

Recanalization using direct stenting before bowel resection for acute-on-chronic superior mesenteric artery occlusion: A case report.

Int J Surg Case Rep 2020 21;68:92-95. Epub 2020 Feb 21.

Emergency and Intensive Care Center, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara, Chiba, 299-0111, Japan.

Introduction: Acute-on-chronic mesenteric ischemia (ACMI) refers to acute mesenteric ischemia (AMI) developing in a patient displaying typical symptoms of chronic mesenteric ischemia (CMI). Delayed treatment can cause short bowel syndrome and increased mortality. Intervention involves intestinal revascularization and resection of the necrotic intestine. However, the revascularization procedure must consider the chronic nature of the occlusion.

Presentation Of Case: A 79-year-old man presented with periumbilical pain for 6 h. AMI was diagnosed, together with chronic superior mesenteric artery occlusion and suspected intestinal necrosis. The symptomatic CMI might have insufficient blood flow to intestines. Endovascular recanalization of the superior mesenteric artery using direct stenting was performed before laparotomy to improve blood flow to the intestines. Subsequent laparotomy revealed approximately 60 cm of ischemic small bowel extending from the jejunum (300 cm anal to the ligament of Treitz) to the ileum (30 cm oral to the terminal ileum). The necrotic bowel was resected without anastomosis. At the second-look operation, further resection was not required.

Discussion: Making a differential diagnosis between acute and acute-on-chronic occlusions is essential for determining the necessity of recanalization and the method of restoring the intestinal blood flow. Here, the patient with symptomatic CMI might have had insufficient blood flow to the intestines despite establishing collateral supply. We determined that recanalization was needed. Direct stenting without predilation could save time to recanalization and result in less risk of distal embolization.

Conclusion: This case suggests prompt recanalization using direct stenting can minimize subsequent bowel resection in patients with ACMI.
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http://dx.doi.org/10.1016/j.ijscr.2020.02.040DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7052432PMC
February 2020

Neuromuscular Electrical Stimulation Improves Energy Substrate Metabolism and Survival in Mice With Acute Endotoxic Shock.

Shock 2020 02;53(2):236-241

Department of Emergency and Critical Care Medicine, Nippon Medical School, Tokyo, Japan.

This study investigated the therapeutic benefits of neuromuscular electrical stimulation (NMES).C57BL/6 mice were administered lipopolysaccharide (LPS; 20 mg/kg body weight) by intraperitoneal injection and divided into control (C) and NMES groups (n = 10-12 each). The latter received NMES to the bilateral gastrocnemius muscle for 1 h at low or high frequency (LF = 2 Hz and HF = 50 Hz, respectively) and low or high voltage (LV = 10 V and HV = 50 V, respectively). In LF-LV and LF-HV groups, NMES was performed twice and the results were compared with those for mice that received one round of NMES. Changes in energy metabolism were measured by indirect calorimetry up to 24 h; survival was evaluated up to 72 h after LPS administration; peroxisome proliferator-activated receptor gamma coactivator (PGC)-1α expression in the liver and gastrocnemius muscle was evaluated by quantitative PCR; and plasma concentration of interleukin (IL)-6 was determined by enzyme-linked immunosorbent assay.Survival was improved only in the LF-LV group with one round of NMES (P < 0.01) and the LF-HV group with two rounds of NMES (P < 0.05). Fatty acid oxidation (FAO) was slightly increased in these two groups, whereas carbohydrate oxidation (CHO) was decreased or not changed. Significant upregulation of PGC-1α in muscle as well as a decrease in plasma IL-6 level were also observed in these two groups (P < 0.05).Thus, NMES exerts therapeutic effects under conditions that induce a mild switch in energy metabolism from glucose to lipid predominant metabolism through PGC-1α upregulation and suppression of inflammation, and may be an effective early intervention even in hemodynamically unstable patients.
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http://dx.doi.org/10.1097/SHK.0000000000001354DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6964866PMC
February 2020

Rare case of acquired perforating dermatosis induced by cetuximab.

J Dermatol 2020 Jan 20;47(1):e11-e12. Epub 2019 Sep 20.

Department of Dermatology, Jichi Medical University, Shimotsuke City, Japan.

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http://dx.doi.org/10.1111/1346-8138.15098DOI Listing
January 2020

Acute generalized exanthematous pustulosis induced by amoxicillin/clavulanic acid, manifesting as severe laryngeal edema.

J Dermatol 2019 Nov 19;46(11):e443-e444. Epub 2019 Jul 19.

Department of Dermatology, Jichi Medical University, Shimotsuke, Japan.

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http://dx.doi.org/10.1111/1346-8138.15016DOI Listing
November 2019

Rapid diagnosis by mass spectrometry of disseminated cryptococcosis clinically mimicking refractory bilateral cellulitis.

J Dermatol 2019 10 31;46(10):e345-e346. Epub 2019 May 31.

Department of Dermatology, Jichi Medical University, Shimotsuke, Japan.

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http://dx.doi.org/10.1111/1346-8138.14944DOI Listing
October 2019

Adalimumab as a successful alternative for the treatment of infliximab-induced sarcoidosis.

J Dermatol 2019 10 24;46(10):e360-e362. Epub 2019 Apr 24.

Department of Dermatology, Jichi Medical University, Shimotsuke, Japan.

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http://dx.doi.org/10.1111/1346-8138.14893DOI Listing
October 2019

An Extremely Rare Complication: Abdominal Aortic Aneurysm Rupture Caused by Migration of a Zenith Main Body Years After Repair of the Suprarenal Stent Separation.

J Endovasc Ther 2019 04 25;26(2):269-272. Epub 2019 Feb 25.

1 Department of Radiology, Nippon Medical School Hospital, Tokyo, Japan.

Purpose: To report an unusual case of an abdominal aortic aneurysm (AAA) rupture caused by migration of a Zenith stent-graft main body years after its separation from the suprarenal stent.

Case Report: A 72-year-old man underwent endovascular aneurysm repair with a Zenith stent-graft for an infrarenal AAA in year 2000. At that time, a femorofemoral bypass was performed because the left external iliac and common femoral arteries were dissected during treatment. In 2013, follow-up computed tomography (CT) showed disconnection of the uncovered proximal stent, which led to a type Ia endoleak. An additional Zenith main body and Large Palmaz XL balloon-expandable stent were deployed; the endoleak disappeared. In 2016, the patient had abdominal pain, and emergency CT showed AAA rupture caused by migration of the first main body deployed in 2000 under the distal edge of the contralateral (left) leg of the additional main body from 2013, which led to a type IIIa endoleak between the 2 main bodies. A converter and iliac legs were deployed to successfully seal the type IIIa endoleak. The patient remains well 18 months after the second repair; CT scans document stable stent-grafts and no endoleak.

Conclusion: Physicians should be aware of the potential risk for AAA rupture caused by late main body migration after treatment for suprarenal stent separation from a Zenith stent-graft.
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http://dx.doi.org/10.1177/1526602819830979DOI Listing
April 2019

Strategy for the treatment of spontaneous isolated visceral artery dissection.

Eur J Radiol Open 2019 7;6:9-15. Epub 2018 Dec 7.

Department of Radiology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan.

Objectives: To determine the incidence of rare spontaneous isolated visceral artery dissection (SIVAD), characterize its pathogenesis, and suggest treatment strategies.

Materials And Methods: We reviewed abdominal contrast-enhanced computed-tomography (CE-CT) scans from January 2005 to December 2016 retrospectively in our institution, identified 47 SIVAD patients and classified them into a symptomatic (n = 22) or asymptomatic group (n = 25). Further, we classified the five types based on the CE-CT images. Patient characteristics, incidence, vascular risk factors, complications, symptoms, treatments outcomes, and morphology features on CE-CT images were analyzed.

Results: SIVAD was seen on 0.09% of all abdominal CE-CT scans, and 0.68% of all abdominal CT-CT scans obtained for the evaluation of acute abdominal symptoms. The asymptomatic group had significantly fewer patients with periarterial fat stranding or branch vessel involvement on CE-CT images (p < 0.01). The mean length of the dissection was longer in the symptomatic group (p < 0.05). In the asymptomatic group, dissection-related abdominal symptoms and complications did not develop; followed-up CE-CT scans showed improvement in the dissection lesions in 1 (4.0%) patient, no changes in 22 (88.0%), and complete remodeling in 2 (8.0%). In the symptomatic group, one patient presented with organ ischemia at diagnosis and five patients developed organ ischemia underwent endovascular intervention. In the remaining 16 patients received nonoperative intervention only, followed-up CE-CT scans showed improvement in 13 (86.7%), and complete remodeling in 2 (13.3%).

Conclusions: Symptomatic SIVAD patients should be hospitalized because some of those may experience organ ischemia or aneurysm formation. Endovascular intervention is a feasible treatment for complications of SIVAD.
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http://dx.doi.org/10.1016/j.ejro.2018.11.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289943PMC
December 2018

Early Transcatheter Arterial Embolization for the American Association for the Surgery of Trauma Grade 4 Blunt Renal Trauma in Two Institutions.

J Nippon Med Sch 2018 ;85(4):204-207

Department of Urology (Chief: S. Kurita), Tachikawa Sogo Hospital.

Objectives: To evaluate the efficacy of early transcatheter arterial embolization for hemodynamically stable patients with The American Association for the Surgery of Trauma (AAST) grade 4 blunt renal trauma.

Materials And Methods: The medical records of consecutive patients with grade 4 blunt renal trauma who were transported to our two critical care centers in Japan and treated with early transcatheter arterial embolization (TAE) between 2001 and 2013 were retrospectively reviewed. Treatment failure was defined as the need for further surgical intervention or re-embolization after initial embolization. We divided these cases into two groups, a group who survived and a group who died, investigating the factors that led to death.

Results: Seventeen patients underwent early TAE, with an average time between presentation and embolization for renal trauma of 125 minutes (66-214 minutes). There was no case of treatment failure. Three of the patients died, but none solely because of renal injury. Significant factors associated with patient death were the number of concomitant injured organs (p=0.04), the presence of pelvic fractures (p<0.01), and the presence of visceral injuries (p<0.01). The presence of lumber fractures (p=0.09) also tended to be associated with patient death.

Conclusions: Early TAE is an effective treatment and should be actively performed for hemodynamically stable patients with grade 4 blunt renal injuries without multiple concomitant organ injuries.
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http://dx.doi.org/10.1272/jnms.JNMS.2018_85-31DOI Listing
November 2018

Long-term survival of a patient with neurofibromatosis type 1 diagnosed with multiple malignant peripheral nerve sheath tumors.

J Dermatol 2019 Jan 2;46(1):e48-e49. Epub 2018 Jul 2.

Department of Dermatology, Jichi Medical University, Tochigi, Japan.

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http://dx.doi.org/10.1111/1346-8138.14527DOI Listing
January 2019

Coil embolization using microballoon assistance combined with the double-catheter technique for a large superior mesenteric arterial pseudoaneurysm and fistula secondary to acute pancreatitis.

J Vasc Surg Cases Innov Tech 2018 Jun 30;4(2):152-155. Epub 2018 Apr 30.

Department of Radiology, Nippon Medical School, Tokyo, Japan.

Pseudoaneurysm of the superior mesenteric artery (SMA) is rare and associated with the risk of massive fatal hemorrhage and acute mesenteric ischemia. We describe a 43-year-old man with acute pancreatitis who presented with an SMA pseudoaneurysm measuring 13 × 12 cm in diameter. The pseudoaneurysm originated between the first and second jejunal arteries and drained into the mesenteric vein. The SMA trunk between the first and second jejunal arteries was embolized with detachable coils using microballoon assistance. After coil placement, arteriography showed the collateral circulation and no perfusion delay of the distal SMA. This technique was useful for isolation of the SMA pseudoaneurysm.
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http://dx.doi.org/10.1016/j.jvscit.2018.02.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6012999PMC
June 2018

Involvement of M1/M2 macrophages in the pathomechanisms of intralymphatic histiocytosis associated with rheumatoid arthritis.

J Dermatol 2019 Jan 15;46(1):e42-e43. Epub 2018 Jun 15.

Department of Dermatology, Jichi Medical University, Shimotsuke, Japan.

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http://dx.doi.org/10.1111/1346-8138.14509DOI Listing
January 2019

Localized scleroderma occurring after treatment of chronic hepatitis C with sofosbuvir and ribavirin.

J Dermatol 2019 Jan 4;46(1):e34-e35. Epub 2018 Jun 4.

Department of Dermatology, Jichi Medical University, Shimotsuke City, Japan.

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http://dx.doi.org/10.1111/1346-8138.14495DOI Listing
January 2019

Bullous pemphigoid complicated by necrotising fasciitis successfully treated with systemic corticosteroids and antibiotics in combination with i.v. immunoglobulin.

Australas J Dermatol 2018 Nov 23;59(4):e313-e314. Epub 2018 May 23.

Department of Dermatology, Jichi Medical University, Shimotsuke, Japan.

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http://dx.doi.org/10.1111/ajd.12859DOI Listing
November 2018

A rare case of drug-induced hypersensitivity syndrome by pirfenidone for idiopathic pulmonary fibrosis.

Allergol Int 2018 Jul 24;67(3):425-426. Epub 2018 Mar 24.

Department of Dermatology, Jichi Medical University, Tochigi, Japan.

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http://dx.doi.org/10.1016/j.alit.2018.02.010DOI Listing
July 2018

Evaluating the Feasibility of Isolated Pancreatic Perfusion for Chemotherapy Using Computed Tomography: An Experimental Study in Pig Models.

Cardiovasc Intervent Radiol 2018 Jul 26;41(7):1081-1088. Epub 2018 Mar 26.

Departments of Radiology/Center for Advanced Medical Technology, Nippon Medical School, 1-1-5 Sendagi, Bunkyou-ku, Tokyo, 113-8602, Japan.

Purpose: Percutaneous isolated pancreatic perfusion (PIPP) is performed along with interventional radiology techniques to obtain high drug concentration by occluding the arterial inlet and venous outlet of the pancreas. The experimental study aimed to evaluate the contrast distribution in PIPP under different flow rates with or without anterior mesenteric artery (AMA) occlusion.

Materials And Methods: This study was approved by a local animal experiment ethics committee. Nine pigs were divided into Groups 1, 2, and 3, by infusion rates of 12, 24, and 36 mL/min. Groups 4 and 5 (3 pigs each) and Group 6 (2 pigs) underwent PIPP at the same respective infusion rates with and without AMA occlusion. Computed tomography (CT) arteriography was performed during PIPP with nonionic contrast media. The enhanced volume was calculated by adding the enhanced area in each slice using 1.25-mm axial images. The percent enhanced volume to the whole pancreas (%eV) was used to simulate drug distribution; the result was compared among groups.

Results: Without AMA occlusion, a larger %eV was obtained with high infusion rates (P = 0.039). The median %eV in Groups 1, 2, and 3 were 57.7, 74.2, and 90.5%, respectively. With AMA occlusion, CT demonstrated duodenal enhancement at an infusion rate of 36 mL/min, and the median %eV in Groups 4, 5, and 6 were 92.8, 95.4, and 98.5%, respectively. A significantly larger %eV was obtained after AMA occlusion (P = 0.031).

Conclusion: A higher infusion rate or AMA occlusion increases the enhanced volume in PIPP in pig models.

Level Of Evidence: No level of evidence.
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http://dx.doi.org/10.1007/s00270-018-1943-yDOI Listing
July 2018

Endovenous Treatment for Acute Massive Pulmonary Thromboembolism.

Ann Vasc Dis 2017 Dec;10(4):338-344

Department of Radiology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan.

Treatment for venous thromboembolic conditions differs significantly depending on whether the condition is acute or chronic. Endovenous treatment is now available for treating the most severe cases of acute massive pulmonary thromboembolism, and the goal is rapid central clot removal to relieve life-threatening pulmonary circulation. Endovenous catheter interventions include catheter-directed thrombolysis and catheter-assisted thrombus removal. The latter is divided into aspiration thrombectomy, fragmentation, and rheolytic thrombectomy. Data from cohort studies indicate that the clinical outcome and safety after open surgical treatment and endovenous treatment may be comparable. This paper reviews the current approaches to endovenous treatment for acute massive pulmonary thromboembolism, and presents our study of hybrid treatment using a combination of local fibrinolysis, mechanical fragmentation, and clot aspiration.
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http://dx.doi.org/10.3400/avd.ra.17-00082DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5835445PMC
December 2017

Neutrophils and the S100A9 protein critically regulate granuloma formation.

Blood Adv 2016 Dec 14;1(3):184-192. Epub 2016 Dec 14.

Laboratory of Cell Regulation, Institute for Virus Research, and.

Macrophages have the potential to undergo cellular transformation into epithelioid cells, and their concentric accumulation in tissues results in the development of granulomas. Although epithelioid cells are an essential and dominant component of granulomas, other cell types have also been detected, which may contribute to the establishment of well-organized granulomas, as observed in human granulomatous diseases. We herein demonstrated that neutrophils may mediate these functions. By taking advantage of the guinea pig pulmonary granuloma model, we obtained a rat monoclonal antibody with unique reactivity to granuloma cells. This antibody, termed G213, reacted with clusters of neutrophils located in the central area of granulomas, and a biochemical analysis identified the G213-reactive antigen as S100A9, a calcium-binding protein of the S100 family, which was expressed abundantly in neutrophils. Consistent with the multifaceted functions attributed to S100A9, including its role in neutrophil extravasation and macrophage activation, the blockade of S100A9 functions with the specific inhibitor, tasquinimod, impaired the formation of organized granulomas with neutrophil cores. These results demonstrate the critical role of neutrophils and the S100A9 protein in granuloma formation. Because intragranuloma S100A9 neutrophils were also detected in humans, these results indicate the potential of tasquinimod, a new anticancer drug candidate, for manipulating human granulomatous diseases.
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http://dx.doi.org/10.1182/bloodadvances.2016000497DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5737174PMC
December 2016
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