Masahiro Yoshida

International University of Health and Welfare

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Endostatin and Vascular Endothelial Growth Factor-A<sub>165</sub>b May Contribute to Classification of Pulmonary Hypertension

Circulation Reports (2021)

Shiro Adachi Ryosuke Kikuchi Shigetake Shimokata Atsuo Suzuki Masahiro Yoshida

Background:Pulmonary hypertension (PH) is characterized by dysregulation of small pulmonary arteries. In addition to endostatin (ES), placenta growth factor (PlGF), vascular endothelial growth factor-A (VEGF-A), and the anti-angiogenesis isoform of VEGF-A (VEGF-A165b) are associated with PH. However, the usefulness of these biomarkers in PH in unknown. We investigated whether these 4 biomarkers are related to PH classification.

Endostatin

10.1253/circrep.cr-20-0096

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Effectiveness of advanced dressings in preventing surgical site infections compared to that of standard dressings in gastrointestinal surgery: A systematic review and meta‐analysis for guideline revision by the Japanese Society for Surgical Infection

Annals of Gastroenterological Surgery (2025)

Keita Kouzu Hironori Tsujimoto Seiichi Shinji Hiroji Shinkawa Koji Tamura

Abstract Introduction This is a systematic review and meta‐analysis of the efficacy of wound coverage using advanced dressings specifically for the prevention of surgical site infections (SSI) in gastrointestinal surgery, as part of the update of the SSI prevention guidelines of the Japan Society for Surgical Infection (JSSI). Methods After searching CENTRAL, PubMed, and ICHUSHI‐Web in July 2024, we included randomized controlled trials (RCTs) comparing advanced dressings and standard dressings for surgical wounds in gastrointestinal surgery (PROSPERO No. CRD42024569084). Three authors independently screened the RCTs. We assessed the risk of bias and certainty of the body of evidence for the extracted data. The primary outcome was superficial SSI, and the secondary outcomes were length of postoperative hospital stay, costs, and allergy. This study was partially supported by the JSSI. Results A total of seven RCTs and 927 patients were included. The use of advanced dressings significantly lowered the risk of SSI compared to that associated with standard dressings (risk ratio: 0.54, 95% confidence intervals: 0.34–0.88). The certainty of the evidence was rated as moderate. According to the subgroup analysis, advanced dressings reduced the risk of SSI in colorectal surgery. Advanced dressings did not reduce the length of postoperative hospital stay or costs compared to that of standard dressings. Allergies were reported in only one patient using silver‐impregnated dressings. Conclusion The use of advanced dressings for primary wounds in gastrointestinal surgery was associated with a significantly lower risk of SSI than that associated with standard dressings.

Guideline

10.1002/ags3.12909

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Two Resected Cases of Biliary Cysadenocarcinoma of the Liver.

The Japanese Journal of Gastroenterological Surgery (1991)

Kazuyuki Matsushita Munemasa Ryu Tomoaki Sano Kazuo Watanabe Masahiro Fujita

近年報告例が増加している肝嚢胞腺癌のうち, 肝嚢胞腺腫から発生した症例と, 単純性肝嚢胞から発生した症例の2例を経験したので報告する.症例1は49歳男性.主訴は突然の上腹部痛, 肝外側区域の一部に乳頭状増殖を示す嚢胞を認め, 肝左葉切除術を施行したところ, 肝嚢胞腺腫から発生した嚢胞腺癌であった.症例2は73歳の女性.肝左葉の単純性嚢胞で5年間経過観察中, 嚢胞の一部に腫瘍の増生を認めたため, 肝左葉切除術を施行した.病理診断は単純性嚢胞から発生した嚢胞腺癌であった.肝嚢胞腺癌の本邦報告例106例中, 記載の明らかな69例を調べると, 単純性肝嚢胞から発生27例, 肝嚢胞腺腫から発生18例, 本来の肝嚢胞腺癌24例であった.この内, 単純性肝嚢胞の経過観察中に発生したものは4例で, 単純性肝嚢胞でも, 癌化を念頭におき, 注意深い経過観察が必要であると思われた.

10.5833/jjgs.24.2041

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Right ventricular pressure overload related to residual thrombotic burden in patients 1 year after acute pulmonary embolism: From the Nagoya PE study

Thrombosis Research (2022)

Yoshihisa Nakano Shiro Adachi Itsumure Nishiyama Kenichiro Yasuda Masahiro Yoshida

Residual pulmonary thrombus is an important factor affecting long-term prognosis after acute pulmonary embolism (PE). In this sub-analysis of the Nagoya PE study, we aimed to evaluate the relationship between residual thrombi detected by our refined computed tomography (CT) imaging protocol and the results of a multifaceted assessment of patients 1 year after acute PE.The Nagoya PE study was a prospective observational study of patients diagnosed with acute PE. At 1 year, patients were evaluated multifacetedly, including by enhanced CT using our refined protocol.Forty-three patients completed full testing at 1 year. Patients were divided into three groups according to the modified CT obstruction index (mCTOI): no pulmonary thrombus, low mCTOI, and high mCTOI. At baseline, left ventricular end-diastolic dimension and tricuspid regurgitation (TR) pressure gradient differed significantly across the three groups. At 1 year, patients with TR velocity > 2.8 m/s were found only in the high mCTOI group (P = .022). No difference was observed in symptoms, exercise tolerance, and quality of life score. Multivariate regression analysis revealed that TR velocity > 2.8 m/s (P = .001) and change in oxygen saturation during a 6-min walking test (P = .043) at 1 year were significantly related to mCTOI at 1 year. High thrombotic burden might be detected in patients with right ventricular pressure overload at diagnosis of acute PE or after 1 year. These patients should be carefully and multifacetedly assessed for potential chronic thromboembolic pulmonary disease or chronic thromboembolic pulmonary hypertension.

10.1016/j.thromres.2022.06.010

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Myocardial metabolic regulation through peroxisome proliferator-activated receptor alpha after myocardial infarction.

PubMed (2003)

Katsuhiko Masamura Nobuyoshi Tanaka Masahiro Yoshida Masayuki Kato Yasuyuki Kawai

Although peroxisome proliferator-activated receptor alpha (PPARalpha) is closely associated with myocardial fatty acid metabolism, the pathophysiological role of PPARalpha in myocardial infarction (MI) is not yet known. The aim of the present study was to clarify the relationship between cardiac energy metabolism and PPARalpha expression in the remodelling of myocardium after MI. We assayed the expression of PPARalpha and several metabolic genes in cultured cardiac cells (myocytes and nonmyocytes) and in MI hearts. PPARalpha was strongly expressed in cardiac myocytes but not in nonmyocytes (mainly fibroblasts). In MI rats, PPARalpha and PPARalpha-regulated genes (lipoprotein lipase, heart-type fatty acid binding protein, long-chain acyl-CoA dehydrogenase and uncoupling protein-3) were decreased concomitantly, whereas uncoupling protein-2 was not decreased in severely ischemic regions. Immunohistochemical staining for PPARalpha was less decreased in borderline myocardium than in sham-operated hearts. Furthermore, in electron microscopic study, there were no lipid droplet accumulations in surviving myocardium after MI. Our results suggest that the reduced expression of PPARalpha is closely related to that of fatty acid metabolism genes in infarcted myocardium, and PPARalpha may play an important role in cardiac energy metabolism during remodelling after MI.

Fatty Acid Metabolism

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Right Ventricular Pressure Overload Related to Residual Thrombotic Burden in Patients 1 Year after Acute Pulmonary Embolism: From the Nagoya PE Study

SSRN Electronic Journal (2022)

Yoshihisa Nakano Shiro Adachi Itsumure Nishiyama Kenichiro Yasuda Masahiro Yoshida

Download This Paper Open PDF in Browser Add Paper to My Library Share: Permalink Using these links will ensure access to this page indefinitely Copy URL Copy DOI

Right ventricular failure

Pressure overload

Ventricular pressure

10.2139/ssrn.4133625

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Citations (1)

[Future outlook on the guidelines for the management of pneumonia--special reference to development of higher quality clinical guidelines (discussion)].

PubMed (2012)

Yoshinori Hasegawa Shigeru Kawano Kazunori Asano Masahiro Yoshida

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[Good's syndrome developing hemophagocytic lymphohistiocytosis following thymectomy].

PubMed (2020)

Michiko Yamada Masahiro Yoshida Shutaro Oiwa Daichi Watanabe Junya Saga

This report presents the case of a 68-year-old female patient previously diagnosed with thymoma by her local doctor. She was referred to our hospital for surgery, and the thymoma was removed and diagnosed as a World Health Organization (WHO) classification type AB thymoma. After surgery, she experienced general malaise, a loss of appetite, and weight loss, so she visited our hospital in May 2019. A blood test showed hypogammaglobulinemia and low B lymphocytes. A bone marrow examination revealed no morphological abnormalities. Flow cytometric analysis indicated a marked decrease in both the B cell-related surface markers CD19 and CD20 and the T cell-related surface marker CD4, and the CD4/CD8 ratio was also low. She was diagnosed with Good's syndrome, and immunoglobulin replacement therapy was administered. She subsequently developed hemophagocytic lymphohistiocytosis (HLH) due to infection and was treated according to the HLH2004 protocol, but she finally succumbed to multiple organ damage as a result of sepsis. Given that Good's syndrome is associated with both humoral and cellular immune dysfunctions, affected patients tend to develop severe infections and have a poor prognosis. In such cases, early detection, regular immunoglobulin replacement therapy, and infection prevention therapies are important.

Hypogammaglobulinemia

Thymectomy

Hemophagocytic Lymphohistiocytosis

Immune Dysregulation

10.11406/rinketsu.61.268

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Fragility fracture of pelvis caused by amenorrheic osteoporosis operated upon using computed-tomography-3D-fluoroscopy matching navigation system: a case report.

DOAJ (DOAJ: Directory of Open Access Journals) (2020)

Masahiro Yoshida Kosuke Tajima Koji Sato

Low-energy trauma fractures of older people cause fragility fractures of the pelvis (FFPs), and secondary amenorrhea triggers osteoporosis that might lead to FFPs. Anorexia nervosa is a major causative factor in secondary amenorrhea, thus, FFPs might be a problem for young anorexia nervosa patients as well as older people. Here, we report a rare case of a young woman with anorexia nervosa who had an FFP, followed by gradual progression of severe sacral deformity.A 49-year-old woman with hypothalamic amenorrhea (a subtype of secondary amenorrhea) caused by anorexia nervosa fell from a chair. She visited a nearby hospital and was diagnosed with an undisplaced sacral fracture; however, she chose to stay at home since the pain was slight and she could still walk. She fell to the floor several times while injured, and 3 months later, she had walking difficulty accompanied with severe pain, and was admitted to our facility. On radiological examination, she was diagnosed with FFP with severe sacral deformity, and was treated surgically. Because of the severe sacral deformity, a computed tomography (CT)-3D-fluoroscopy matching navigation system was used during surgery to support appropriate placement of percutaneous iliosacral (IS) and transiliac-trans-sacral (TITS) screws.To our knowledge, this is the first report of FFP caused by amenorrheic osteoporosis, treated by matching navigation. This matching navigation could be a supportive tool in inserting IS and TITS screws during surgery for FFPs, especially in cases with severe deformity.

Anorexia nervosa

Pelvic fracture

10.20407/fmj.2019-021

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Diagnosis of Abnormal Diaphragm Motion after Cardiothoracic Surgery: Ultrasound Performed by a Cardiac Intensivist vs. Fluoroscopy

Congenital Heart Disease (2010)

Joan Sánchez-de-Toledo Ricardo Muñoz Douglas Landsittel Dana Shiderly Masahiro Yoshida

Objectives. Abnormal diaphragmatic motion secondary to phrenic nerve injury is not uncommon after pediatric cardiothoracic surgery. Fluoroscopy is the most frequent method of diagnosis but it carries risks associated with transportation of critically ill children and exposure to ionizing radiation. Ultrasonography, a reliable diagnostic method in adults, eliminates both concerns. Since most cardiac intensivists are trained in echocardiography, we tested the hypothesis that chest ultrasound performed by a cardiac intensivist is faster than fluoroscopy, and is highly accurate in predicting fluoroscopy results, therefore serving as an equally useful diagnostic test. Design. Prospective study in consecutive pediatric patients with suspected abnormal diaphragmatic motion after cardiothoracic surgery. All patients underwent fluoroscopy and ultrasound study of the diaphragm. Ultrasound was performed by a pediatric cardiac intensivist and a trainee. Kappa statistic was calculated to assess concordance between both ultrasound readings. Sensitivity, specificity, and positive and negative predictive values (PPV and NPV) were calculated to assess accuracy of each ultrasound test in predicting fluoroscopy results. Results. Twenty-five patients with median age 3 months (12 days–11 years) and median weight of 3.8 kg (2.5–29 kg) were included. The ultrasound diagnosis of the cardiac intensivist was perfectly accurate (100% sensitivity, specificity, and PPV and NPV) in predicting fluoroscopy results. The ultrasound performed by the trainee achieved 85.7% sensitivity, 94.4% NPV, and 100% specificity relative to fluoroscopy. The interoperator reliability of chest ultrasound was 0.89 (95% confidence interval 0.69–1). Delay between clinical suspicion and the diagnostic tests was 15 minutes (5 minutes–2.5 hours) for ultrasound and 17 hours (60 minutes–82 hours) for fluoroscopy (P < 0.001). Conclusions. Chest ultrasound performed by cardiac intensivists allows for an early and accurate diagnosis of abnormal diaphragmatic motion, as evidenced by their ability to predict fluoroscopy findings in pediatric cardiothoracic patients. Training in ultrasound-guided assessment of diaphragmatic motion should be reinforced during pediatric cardiac intensive care fellowship.

Intensivist

Diaphragm (acoustics)

10.1111/j.1747-0803.2010.00431.x

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Citations (74)