Takayuki Abe

Keio University, Edo, Tōkyō, Japan

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Publications (35)117.25 Total impact

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    ABSTRACT: IntroductionLittle is known about oxyhemoglobin (oxy-Hb) levels in the cerebral tissue during the development of anoxic and ischemic brain injury. We hypothesized that the estimated cerebral oxy-Hb level, a product of Hb and regional cerebral oxygen saturation (rSO2), determined at hospital arrival may reflect the level of neuroprotection in patients with post-cardiac arrest syndrome (PCAS).Methods The Japan Prediction of neurological Outcomes in patients with Post cardiac arrest (J-POP) registry is a prospective, multicenter, cohort study to test whether rSO2 predicts neurological outcomes after out-of-hospital cardiac arrest (OHCA). This study assessed a subgroup of consecutive patients who fulfilled the J-POP registry criteria and successfully achieved return of spontaneous circulation (ROSC) from OHCA. The primary outcome measure was the neurological status at 90 days.ResultsWe analyzed data from 495 consecutive comatose survivors who were successfully resuscitated from OHCA, including 119 comatose patients with prehospital return of spontaneous circulation (ROSC; 24.0%) and 376 cardiac arrests at hospital arrival. In total, 75 patients (15.1%) presented with good neurological outcomes. Univariate analysis revealed that the cerebral oxy-Hb levels were significantly higher in patients with good outcomes. Multivariate logistic regression using the backward elimination method confirmed that the oxy-Hb level was a significant predictor of good neurological outcomes (adjusted odds ratio: 1.27, 95% confidence interval (CI): 1.11 to 1.46). Analysis of the area under the receiver operating characteristic curve (AUC) revealed that an oxy-Hb cut-off of 5.5 provided optimal sensitivity and specificity for predicting good neurological outcomes (AUC: 0.87, 95% CI: 0.83 to 0.91; sensitivity: 77.3%; specificity: 85.6%). The oxy-Hb level appeared to be an excellent prognostic indicator with significant advantages over rSO2 and base excess according to AUC analysis. The significant trend for good neurological outcomes was consistent, even in the subgroup of patients who achieved return of spontaneous circulation upon hospital arrival (1st quartile: 0%; 2nd quartile: 16.7%; 3rd quartile: 29.4%; 4th quartile: 53.3%, P <0.05).Conclusions The cerebral oxy-Hb level may predict neurological outcomes and is a simple and excellent indicator of neuroprotection in patients with PCAS.Trial registrationUMIN Clinical Trials Registry UMIN000005065. Registered 1 April 2011.
    Critical care (London, England) 08/2014; 18(4):500. · 4.72 Impact Factor
  • Journal of clinical psychopharmacology 04/2014; · 5.09 Impact Factor
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    ABSTRACT: Objectives To compare quantitative and subjective image quality between virtual monochromatic spectral (VMS) and conventional polychromatic 120-kVp imaging performed during the same abdominal computed tomography (CT) examination. Materials and methods Our institutional review board approved this prospective study; each participant provided written informed consent. Fifty-one patients underwent sequential fast kVp-switching dual-energy (80/140 kVp, volume CT dose index: 12.7 mGy) and single-energy (120 kVp, 12.7 mGy) abdominal enhanced CT over an 8-cm scan length with a random acquisition order and a 4.3-s interval. VMS images with filtered back projection (VMS-FBP) and adaptive statistical iterative reconstruction (so-called hybrid IR) (VMS-ASIR) (at 70 keV), as well as 120-kVp images with FBP (120-kVp-FBP) and ASIR (120-kVp-ASIR), were generated from dual-energy and single-energy CT data, respectively. The objective image noises, signal-to-noise ratios and contrast-to-noise ratios of the liver, kidney, pancreas, spleen, portal vein and aorta, and the lesion-to-liver and lesion-to-kidney contrast-to-noise ratios were measured. Two radiologists independently and blindly assessed the subjective image quality. The results were analyzed using the paired t -test, Wilcoxon signed rank sum test and mixed-effects model with Bonferroni correction. Results VMS-ASIR images were superior to 120-kVp-FBP, 120-kVp-ASIR and VMS-FBP images for all the quantitative assessments and the subjective overall image quality (all P < 0.001), while VMS-FBP images were superior to 120-kVp-FBP and 120-kVp-ASIR images (all P < 0.004). Conclusions VMS images at 70 keV have a higher image quality than 120-kVp images, regardless of the application of hybrid IR. Hybrid IR can further improve the image quality of VMS imaging.
    European Journal of Radiology 01/2014; · 2.51 Impact Factor
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    ABSTRACT: Dry eye disease (DED) is defined as a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear-film instability, with potential damage to the ocular surface. It is thought to be associated with reduced quality of life (QOL). The aim of the present study was to investigate the effects of DED on health-related QOL in Japanese university sedentary office workers who are daily users of visual display terminal. In this study, 163 university staff (99 male and 64 female), aged 23-69 years, served as study subjects. Subjects were asked to answer the following three questions. (1) How often do your eyes feel dry? (2) How often do your eyes feel irritated? (3) Have you ever been diagnosed by a clinician as having dry eye syndrome? Sixty-eight subjects who answered "constantly," "often", or "sometimes" to both questions 1 and 2 were classified as the DED Group, and the remaining 95 were defined as the Non-DED Group. QOL was assessed by the SF-36 questionnaire, which consisted of 36 items to produce three summary scores, namely, mental, physical, and role/social component summary scores. For males, the DED Group had significantly lower scores than the Non-DED Group for mental component summary (MCS) (P = 0.005). In multiple regression analysis, MCS scores were adversely related to DED in males (P = 0.015). DED was associated with worsened QOL. DED should be regarded as a factor that can lead to deterioration of mental health.
    The Tohoku Journal of Experimental Medicine 01/2014; 233(3):215-20. · 1.37 Impact Factor
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    ABSTRACT: Background Dual-energy CT technology enables acquisition of virtual unenhanced (VUE) images from contrast-enhanced scans. Objective To assess the feasibility of coronary artery calcium (CAC) scoring on VUE images derived from fast kVp-switching dual-energy coronary CT angiography. Methods Twenty-seven patients underwent true non-contrast CAC scoring CT followed by routine single-energy (120-kVp) and fast kVp-switching dual-energy coronary CT angiography, in a random acquisition order, on the same day. We calculated the CAC scores on true non-contrast and VUE images. The image noises, signal-to-noise and contrast-to-noise ratios of the aorta and coronary arteries were measured on both the single-energy coronary CT angiography images and dual-energy coronary CT angiography images (70-keV virtual monochromatic spectral images). Pearson’s correlation coefficient test and paired t-test were used for the statistical analysis. Results Excellent correlation was observed between the CAC scores on the true non-contrast and those on the VUE images (r = 0.88, P < 0.001). Compared with single-energy coronary CT angiography, dual-energy coronary CT angiography showed significantly reduced image noise and increased signal-to-noise and contrast-to-noise ratios in all regions (all P < 0.001). The effective dose of dual-energy coronary CT angiography (4.3 ± 0.3 mSv) was significantly lower than that of true non-contrast CAC scoring CT plus single-energy coronary CT angiography (5.4 ± 0.7 mSv) (P < 0.0001). Conclusions Excellent correlation was observed between the CAC scores on the VUE images and true non-contrast images. Thus, fast kVp-switching dual-energy coronary CT angiography could allow prediction of the true CAC scores, potentially reducing the total radiation exposure and image acquisition time by obviating the need for true non-contrast CAC scoring CT.
    Journal of Cardiovascular Computed Tomography 01/2014; · 2.55 Impact Factor
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    ABSTRACT: The aim of this study was to clarify the relationship between baseline beta cell function and future glycated albumin (GA) to glycated hemoglobin ratio (GA/HbA1c) in patients with type 2 diabetes. In our retrospective cohort, 210 type 2 diabetic patients who had been admitted to our hospital and in whom HbA1c and GA had been measured at baseline and 2 years after admission were included in this study. Baseline beta cell function was assessed by postprandial C-peptide immunoreactivity index (PCPRI) during admission. With intensification of treatment during admission, HbA1c and GA were significantly decreased 1 year and 2 years after admission. While baseline HbA1c was not significantly correlated with HbA1c after 2 years, baseline GA/HbA1c was strongly correlated with GA/HbA1c after 2 years (r = 0.575, P <0.001). When the patients were divided into two groups according to median PCPRI, patients with low PCPRI showed higher GA/HbA1c both at baseline and after 2 years compared to those with high PCPRI. There was a significant negative correlation between PCPRI and GA/HbA1c after 2 years (r = -0.379, P <0.001). Multiple regression analysis revealed that PCPRI was an independent predictor of GA/HbA1c after 2 years. In conclusion, our findings suggest that lower beta cell function is associated with sustained higher GA/HbA1c ratio in patients with type 2 diabetes.
    Endocrine Journal 11/2013; · 2.23 Impact Factor
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    ABSTRACT: [Purpose] To determine if glaucomatous visual field defect severity is associated with fear of falling. [Methods] This is a cross-sectional study. A total of 387 consecutive subjects with primary open-angle glaucoma (POAG) were enrolled in this study along with 293 ocular disease-free control subjects, who were screened at the same institutions. We defined mild POAG as mean deviation (MD) of -6 dB or better, moderate POAG as MD of -6 to -12 dB, and severe POAG as MD of -12 dB or worse in the better eye. All participants were requested to answer a questionnaire on fear of falling. Associations between POAG severity and the prevalence of fear of falling were evaluated with the Cochran-Armitage trend test. Multivariable factors including age-adjusted odds ratios (ORs) for the prevalence of fear of falling and 95% confidence intervals (CIs) were evaluated with logistic regression models. [Results] The prevalence of fear of falling was 35/293 (11.9%) in the control group, 38/313 (12.1%) in the mild POAG group, 12/48 (25.0%) in the moderate POAG group, and 6/26 (23.1%) in the severe POAG group, and the trend was statistically significant (P=0.028 Cochran-Armitage trend test). The adjusted ORs for prevalence in the mild, moderate, and severe POAG groups compared with that in the control group were 1.44 (95% CI: 0.83 to 2.51), 2.33 (95% CI: 1.00 to 5.44) and 4.06 (95% CI: 1.39 to 11.90), respectively. [Conclusions] Among patients with POAG, the severity of visual field defects is associated with fear of falling.
    Investigative ophthalmology & visual science 10/2013; · 3.43 Impact Factor
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    ABSTRACT: To investigate the long-term effects of postoperative flat anterior chamber (FAC) development on outcomes following trabeculectomy with mitomycin C. This was a retrospective cohort study. Data on 383 consecutive patients (383 eyes) who underwent trabeculectomy at our institution between 1999 and 2009 were followed up. Patients who developed FAC after trabeculectomy and patients with maintained anterior chamber were evaluated. The primary outcome variable was the success of the initial trabeculectomy, which was defined at 3 different levels by the achievement of the following intraocular pressure (IOP)-related criteria without secondary IOP-lowering surgery: (a) IOP ≤ 12 mmHg and ≤30 % reduction in IOP from the preoperative level; (b) IOP ≤ 16 mmHg and ≤20 % reduction in IOP; and (c) IOP ≤ 21 mmHg. The hazard ratios (HRs) for the failure of trabeculectomy caused by FAC within 5 years of surgery were examined in conjunction with the Cox proportional hazards regression model. FAC was observed in 90 of the 383 eyes examined (23.4 %). Postoperative mild FAC was associated with the long-term success of trabeculectomy when evaluated according to our strictest success criterion, Criterion-A [HR = 0.72 (95 % CI 0.53-0.98); P = 0.04]. In contrast, severe FAC was inversely associated with the long-term success of the surgery when evaluated according to our most lenient criterion, Criterion-C [HR = 1.93 (95 % CI 1.16-3.22); P = 0.01]. Mild postoperative FAC after trabeculectomy is associated with a favorable long-term outcome, whereas severe postoperative FAC leads to an unfavorable prognosis.
    Japanese Journal of Ophthalmology 08/2013; · 1.27 Impact Factor
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    ABSTRACT: It remains unclear regarding the contribution of each individual symptom in predicting the outcome in major depressive disorder (MDD). The objective of this analysis was to evaluate trajectories of individual symptoms over time to identify which specific depressive item(s) could predict subsequent clinical response. The data of 2874 outpatients with nonpsychotic MDD who received citalopram for up to 14 weeks in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial were analyzed. Average trajectories of individual symptoms over time were estimated for remitters and non-remitters. Moreover, specific symptoms whose improvement at week 2 predicted remission were identified, using binary logistic regression analysis. Trajectories were significantly different between remitters and non-remitters in all depressive symptoms. All depressive symptoms in the 16-item Quick Inventory of Depressive Symptomatology, Self-Report (QIDS-SR16) in the two groups, except for hypersomnia and weight change in non-remitters, substantially improved within 2 weeks and gradually continued to improve thereafter throughout the 14 weeks. Early improvements in the following five symptoms, in order of magnitude, in the QIDS-SR16 were significantly associated with remission: sad mood, negative self-view, feeling slowed down, low energy, and restlessness (P<0.001, P<0.001, P=0.001, P=0.004, P=0.021). The participants were limited to the nonpsychotic MDD outpatients who received citalopram. Further, symptomatology was not evaluated at the very beginning of treatment. While the data pertain to citalopram and replication is necessary for other antidepressants, early improvements in certain core depressive symptoms may serve as a predictor of subsequent remission.
    Journal of affective disorders 07/2013; · 3.76 Impact Factor
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    ABSTRACT: Impact of dose reduction of atypical antipsychotics on cognitive function has not been investigated in stable patients with schizophrenia. In this open-label, 28-week, randomized controlled trial, stable patients with schizophrenia treated with risperidone or olanzapine were randomly assigned to the reduction group (dose reduced by 50% in 4 weeks and then maintained) or maintenance group (dose kept constant). Assessments at baseline and week 28 included the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), Positive and Negative Syndrome Scale (PANSS), and Drug-Induced Extrapyramidal Symptoms Scale (DIEPSS). Sixty-one patients were enrolled; 2 of 31 (6.5%) and 5 of 30 (16.7%) patients prematurely withdrew from the study in the reduction and maintenance groups, respectively. While no significant differences in change in the PANSS total score were observed between the 2 groups, the reduction group showed significantly greater improvements in the RBANS and DIEPSS total scores compared with the maintenance group (mean ± SD, +7.0±7.1 vs -0.1±8.0, P < .001; -0.9±1.7 vs +0.1±1.2, P = .010, respectively). This 6-month pilot study suggests that risperidone or olanzapine dose reduction of 50% can improve cognitive function for stable patients with schizophrenia. Due to the open-label design, small sample size, and short study duration, however, there is a need to confirm the finding through double-blind, larger scale trials with longer follow-up periods. Moreover, potential risks of relapse following antipsychotic dose reduction should be thoroughly investigated in longer term studies.
    Schizophrenia Bulletin 07/2013; · 8.80 Impact Factor
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    ABSTRACT: OBJECTIVES: To compare the diagnostic performance of tomosynthesis with that of chest radiography for the detection of pulmonary emphysema, using multidetector computed tomography (MDCT) as reference. METHODS: Forty-eight patients with and 63 without pulmonary emphysema underwent chest MDCT, tomosynthesis and radiography on the same day. Two blinded radiologists independently evaluated the tomosynthesis images and radiographs for the presence of pulmonary emphysema. Axial and coronal MDCT images served as the reference standard and the percentage lung volume with attenuation values of -950 HU or lower (LAA-950) was evaluated to determine the extent of emphysema. Receiver-operating characteristic (ROC) analysis and generalised estimating equations model were used. RESULTS: ROC analysis revealed significantly better performance (P < 0.0001) of tomosynthesis than radiography for the detection of pulmonary emphysema. The average sensitivity, specificity, positive predictive value and negative predictive value of tomosynthesis were 0.875, 0.968, 0.955 and 0.910, respectively, whereas the values for radiography were 0.479, 0.913, 0.815 and 0.697, respectively. For both tomosynthesis and radiography, the sensitivity increased with increasing LAA-950. CONCLUSIONS: The diagnostic performance of tomosynthesis was significantly superior to that of radiography for the detection of pulmonary emphysema. In both tomosynthesis and radiography, the sensitivity was affected by the LAA-950. KEY POINTS : • Tomosynthesis showed significantly better diagnostic performance for pulmonary emphysema than radiography. • Interobserver agreement for tomosynthesis was significantly higher than that for radiography. • Sensitivity increased with increasing LAA -950 in both tomosynthesis and radiography. • Tomosynthesis imparts a similar radiation dose to two projection chest radiography. • Radiation dose and cost of tomosynthesis are lower than those of MDCT.
    European Radiology 03/2013; · 4.34 Impact Factor
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    ABSTRACT: To clarify predictive values of C-reactive protein (CRP) and high-molecular-weight (HMW) adiponectin for development of metabolic syndrome. We conducted a prospective cohort study of Japanese workers who had participated in an annual health checkup in 2007 and 2011. A total of 750 subjects (558 men and 192 women, age 46±8 years) who had not met the criteria of metabolic syndrome and whose CRP and HMW-adiponectin levels had been measured in 2007 were enrolled in this study. Associations between CRP, HMW-adiponectin and development of metabolic syndrome after 4 years were assessed by logistic regression analysis and their predictive values were compared by receiver operating characteristic analysis. Among 750 subjects, 61 (8.1%) developed metabolic syndrome defined by modified National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria and 53 (7.1%) developed metabolic syndrome defined by Japan Society for the Study of Obesity (JASSO) in 2011. Although CRP and HMW-adiponectin were both significantly correlated with development of metabolic syndrome, multivariate logistic regression analysis revealed that HMW-adiponectin but not CRP was associated with metabolic syndrome independently of BMI or waist circumference. Adding these biomarkers to BMI or waist circumference did not improve the predictive value for metabolic syndrome. Our findings indicate that the traditional markers of adiposity such as BMI or waist circumference remain superior markers for predicting metabolic syndrome compared to CRP, HMW-adiponectin, or the combination of both among the Japanese population.
    PLoS ONE 01/2013; 8(9):e73430. · 3.53 Impact Factor
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    ABSTRACT: Objectives. We investigated the relationship between the stage of diabetic retinopathy and pulse wave velocity (PWV). Methods. This was a cross-sectional study of 689 patients (406 men and 283 women) with type 2 diabetes who were admitted to our hospital from 2004 to 2007. Brachial-ankle pulse wave velocity (baPWV) was measured by an arterial pressure measurement device as PWV/ABI. Diagnosis of diabetic retinopathy was made by ophthalmologists based on the Davis classification: no diabetic retinopathy (NDR), simple retinopathy (SDR), pre-proliferative retinopathy (pre-PDR), and proliferative retinopathy (PDR). Results. There was a significant difference in PWV between patients without diabetic retinopathy (1657.0 ± 417.9 m/s (mean ± SD)) and with diabetic retinopathy (1847.1 ± 423.9 m/s) (P < 0.001). In addition, the stage of diabetic retinopathy was associated with aortic PWV (1657.0 ± 417.9 m/s in NDR (n = 420), 1819.4 ± 430.3 m/s in SDR (n = 152), 1862.1 ± 394.0 m/s in pre-PDR (n = 54), and 1901.1 ± 433.5 m/s in PDR (n = 63) (P < 0.001)). Conclusions. In patients with diabetic retinopathy, even in those with SDR, PWV was higher than that in patients without diabetic retinopathy. Physicians should therefore pay attention to the value of PWV and macroangiopathy regardless of the stage of diabetic retinopathy.
    Journal of Diabetes Research 01/2013; 2013:193514. · 3.54 Impact Factor
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    ABSTRACT: The aim of this study was to clarify the association between C-peptide immunoreactivity (CPR), a marker of beta cell function, and future glycemic control in patients with type 2 diabetes. We conducted a retrospective analysis of 513 consecutive patients with type 2 diabetes who were admitted to our hospital between 2000 and 2007 and followed up for 2 years. Serum and urinary CPR levels were measured during admission, and CPR index was calculated as the ratio of CPR to plasma glucose. The associations between these markers at baseline and glycemic control after 2 years were assessed by means of logistic regression models. After 2 years, 167 patients (32.6%) showed good glycemic control (HbA1c <6.9%). Baseline serum and urinary CPR indices were significantly associated with good glycemic control after 2 years, and the postprandial CPR to plasma glucose ratio (postprandial CPR index) showed the strongest association (odds ratio (OR) 1.29, 95% confidence interval (CI) 1.12-1.50, P = 0.001) among CPR indices. Multivariate analyses showed consistent results (OR 1.23, 95%CI 1.03-1.48, P = 0.021). In conclusion, preserved beta cell function at baseline was associated with better glycemic control thereafter in patients with type 2 diabetes.
    Endocrine Journal 12/2012; · 2.23 Impact Factor
  • Acta Diabetologica 12/2012; · 4.63 Impact Factor
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    ABSTRACT: OBJECTIVE: To compare the diagnostic characteristics of evaluation of myometrial invasion (MI) retrospectively between preoperative magnetic resonance imaging (MRI) and intraoperative frozen sections. DESIGN: A retrospective study. Setting University hospital. Sample 201 patients diagnosed with endometrial carcinoma. METHODS: All patients underwent preoperative MRI and 111 patients among them also underwent intraoperative frozen section assessment. The final pathological evaluation was used as the definitive diagnosis. MAIN OUTCOME MEASURES: In patients who underwent MRI and frozen section (N=111), the accuracies were compared for detection of MI and detection of deep invasion (defined as ≥50% invasion). RESULTS: The accuracy, sensitivity, and specificity of MRI for detection of MI were 65.8%, 58.8%, and 88.5%, respectively, and those in frozen section were 90.1%, 90.6%, and 88.5%, respectively. The accuracy and sensitivity of frozen section were significantly higher (p <0.001, p <0.001), while the specificity did not differ between the two methods (p =1.000). The accuracy, sensitivity, and specificity of MRI for detection of deep invasion were 83.8%, 69.2%, and 88.2%, respectively, and those of frozen section were 93.7%, 73.1%, and 100.0%, respectively. The accuracy and specificity of frozen section were significantly higher (p =0.007, p <0.001), while sensitivity did not show a significant difference (p =0.999). CONCLUSION: In assessment of MI, the accuracy of frozen section was significantly higher than that of MRI. Since the diagnostic characteristics differ between two methods, additional intraoperative frozen section is recommended for more accurate assessment of MI when MRI is negative for the presence of any MI or positive for the presence of deep invasion. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica © 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
    Acta Obstetricia Et Gynecologica Scandinavica 11/2012; · 1.85 Impact Factor
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    ABSTRACT: BACKGROUND: CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION LEADS TO PULMONARY HYPERTENSION AND RIGHT-SIDED HEART FAILURE. THE PURPOSE OF THIS STUDY WAS TO INVESTIGATE THE EFFICACY OF PERCUTANEOUS TRANSLUMINAL PULMONARY ANGIOPLASTY (PTPA) FOR THE TREATMENT OF CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION.METHODS AND RESULTS: TWENTY-NINE PATIENTS WITH CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION UNDERWENT PTPA. ONE PATIENT HAD A WIRING PERFORATION AS A COMPLICATION OF PTPA AND DIED 2 DAYS AFTER THE PROCEDURE. IN THE REMAINING 28 PATIENTS, PTPA DID NOT PRODUCE IMMEDIATE HEMODYNAMIC IMPROVEMENT AT THE TIME OF THE PROCEDURE. HOWEVER, AFTER FOLLOW-UP (6.0 6.9 MONTHS), NEW YORK HEART ASSOCIATION FUNCTIONAL CLASSIFICATIONS AND LEVELS OF PLASMA B-TYPE NATRIURETIC PEPTIDE SIGNIFICANTLY IMPROVED (BOTH P0.01). HEMODYNAMIC PARAMETERS ALSO SIGNIFICANTLY IMPROVED (MEAN PULMONARY ARTERIAL PRESSURE, 45.3 9.8 VERSUS 31.8 10.0 MM HG; CARDIAC OUTPUT, 3.6 1.2 VERSUS 4.6 1.7 L/MIN, BASELINE VERSUS FOLLOW-UP, RESPECTIVELY; BOTH P0.01). TWENTY-SEVEN OF 51 PROCEDURES IN TOTAL (53%), AND 19 OF 28 FIRST PROCEDURES (68%), HAD REPERFUSION PULMONARY EDEMA AS THE CHIEF COMPLICATION. PATIENTS WITH SEVERE CLINICAL SIGNS AND/OR SEVERE HEMODYNAMICS AT BASELINE HAD A HIGH RISK OF REPERFUSION PULMONARY EDEMA.CONCLUSIONS: PTPA IMPROVED SUBJECTIVE SYMPTOMS AND OBJECTIVE VARIABLES, INCLUDING PULMONARY HEMODYNAMICS. PTPA MAY BE A PROMISING THERAPEUTIC STRATEGY FOR THE TREATMENT OF CHRONIC THROMBOEMBOLIC PULMONARY HYPERTENSION.CLINICAL TRIAL REGISTRATION: URL: http://www.umin.ac.jp. Unique identifier: UMIN000001572.
    Circulation Cardiovascular Interventions 11/2012; · 6.54 Impact Factor
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    ABSTRACT: All clinical and biological manifestations related to postcardiac arrest (CA) syndrome are attributed to ischemia-reperfusion injury in various organs including brain and heart. Molecular hydrogen (H(2)) has potential as a novel antioxidant. This study tested the hypothesis that inhalation of H(2) gas starting at the beginning of cardiopulmonary resuscitation (CPR) could improve the outcome of CA. Ventricular fibrillation was induced by transcutaneous electrical epicardial stimulation in rats. After 5 minutes of the subsequent CA, rats were randomly assigned to 1 of 4 experimental groups at the beginning of CPR: mechanical ventilation (MV) with 2% N(2) and 98% O(2) under normothermia (37°C), the control group; MV with 2% H(2) and 98% O(2) under normothermia; MV with 2% N(2) and 98% O(2) under therapeutic hypothermia (TH), 33°C; and MV with 2% H(2) and 98% O(2) under TH. Mixed gas inhalation and TH continued until 2 hours after the return of spontaneous circulation (ROSC). H(2) gas inhalation yielded better improvement in survival and neurological deficit score (NDS) after ROSC to an extent comparable to TH. H(2) gas inhalation, but not TH, prevented a rise in left ventricular end-diastolic pressure and increase in serum IL-6 level after ROSC. The salutary impact of H(2) gas was at least partially attributed to the radical-scavenging effects of H(2) gas, because both 8-OHdG- and 4-HNE-positive cardiomyocytes were markedly suppressed by H(2) gas inhalation after ROSC. Inhalation of H(2) gas is a favorable strategy to mitigate mortality and functional outcome of post-CA syndrome in a rat model, either alone or in combination with TH.
    Journal of the American Heart Association. 10/2012; 1(5):e003459.
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    ABSTRACT: OBJECTIVES: To assess the effectiveness of adaptive iterative dose reduction (AIDR) and AIDR 3D in improving the image quality in low-dose chest CT (LDCT). MATERIALS AND METHODS: Fifty patients underwent standard-dose chest CT (SDCT) and LDCT simultaneously, performed under automatic exposure control with noise index of 19 and 38 (for a 2-mm slice thickness), respectively. The SDCT images were reconstructed with filtered back projection (SDCT-FBP images), and the LDCT images with FBP, AIDR and AIDR 3D (LDCT-FBP, LDCT-AIDR and LDCT-AIDR 3D images, respectively). On all the 200 lung and 200 mediastinal image series, objective image noise and signal-to-noise ratio (SNR) were measured in several regions, and two blinded radiologists independently assessed the subjective image quality. Wilcoxon's signed rank sum test with Bonferroni's correction was used for the statistical analyses. RESULTS: The mean dose reduction in LDCT was 64.2% as compared with the dose in SDCT. LDCT-AIDR 3D images showed significantly reduced objective noise and significantly increased SNR in all regions as compared to the SDCT-FBP, LDCT-FBP and LDCT-AIDR images (all, P≤0.003). In all assessments of the image quality, LDCT-AIDR 3D images were superior to LDCT-AIDR and LDCT-FBP images. The overall diagnostic acceptability of both the lung and mediastinal LDCT-AIDR 3D images was comparable to that of the lung and mediastinal SDCT-FBP images. CONCLUSIONS: AIDR 3D is superior to AIDR. Intra-individual comparisons between SDCT and LDCT suggest that AIDR 3D allows a 64.2% reduction of the radiation dose as compared to SDCT, by substantially reducing the objective image noise and increasing the SNR, while maintaining the overall diagnostic acceptability.
    European journal of radiology 08/2012; · 2.65 Impact Factor
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    ABSTRACT: The aim of this study was to assess the effectiveness of a model-based iterative reconstruction (MBIR) in improving image quality and diagnostic performance of ultralow-dose computed tomography (ULDCT) of the lung. The institutional review board approved this study, and all patients provided written informed consent. Fifty-two patients underwent low-dose computed tomography (LDCT) (screening-dose, 50 mAs) and ULDCT (4 mAs) of the lung simultaneously. The LDCT images were reconstructed with filtered back projection (LDCT-FBP images) and ULDCT images were reconstructed with both MBIR (ULDCT-MBIR images) and FBP (ULDCT-FBP images). On all the 156 image series, objective image noise was measured in the thoracic aorta, and 2 blinded radiologists independently assessed subjective image quality. Another 2 blinded radiologists independently evaluated the ULDCT-MBIR and ULDCT-FBP images for the presence of noncalcified and calcified pulmonary nodules; LDCT-FBP images served as the reference. Paired t test, Wilcoxon signed rank sum test, and free-response receiver-operating characteristic analysis were used for statistical analysis of the data. Compared with LDCT-FBP and ULDCT-FBP, ULDCT-MBIR had significantly reduced objective noise (both P <; 0.001). Subjective noise on the ULDCT-MBIR images was comparable with that on the LDCT-FBP images but lower than that on the ULDCT-FBP images (P <; 0.001). Artifacts on ULDCT-MBIR images were more numerous than those on the LDCT-FBP images (P = 0.007) but fewer than those on the ULDCT-FBP images (P <; 0.001). Compared with the LDCT-FBP images, ULDCT-MBIR and ULDCT-FBP images showed reduced image sharpness (both P <; 0.001). All the ULDCT-MBIR images showed a blotchy pixelated appearance; however, the performance of ULDCT-MBIR was significantly superior to that of ULDCT-FBP for the detection of noncalcified pulmonary nodules (P = 0.002). The average true-positive fractions for significantly sized noncalcified nodules (≥4 mm) and small noncalcified nodules (<;4 mm) on the ULDCT-MBIR images were 0.944 and 0.884, respectively, when LDCT-FBP images were used as reference. All of the calcified nodules were detected by both the observers on both the ULDCT-MBIR and ULDCT-FBP images. As compared with FBP, MBIR enables significant reduction of the image noise and artifacts and also better detection of noncalcified pulmonary nodules on ULDCT of the lung. Compared with LDCT-FBP images, ULDCT-MBIR images showed significantly reduced objective noise and comparable subjective image noise. Almost all of the noncalcified nodules and all of the calcified nodules could be detected on the ULDCT-MBIR images, when LDCT-FBP images were used as the reference.
    Investigative Radiology 08/2012; 47(8):482-9. · 5.46 Impact Factor

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138 Citations
117.25 Total Impact Points

Institutions

  • 2010–2014
    • Keio University
      • • Department of Obstetrics and Gynecology
      • • Department of Internal Medicine
      Edo, Tōkyō, Japan
  • 2012
    • Clinical Research Hospital, Tokyo
      Edo, Tōkyō, Japan