フルテキストURL K0005280_fulltext.pdf
著者 Ishigami, Shuta| Ohtsuki, Shinichi| Tarui, Suguru| Ousaka, Daiki| Eitoku, Takahiro| Kondo, Maiko| Okuyama, Michihiro| Kobayashi, Junko| Baba, Kenji| Arai, Sadahiko| Kawabata, Takuya| Yoshizumi, Ko| Tateishi, Atsushi| Kuroko, Yosuke| Iwasaki, Tatsuo| Sato, Shuhei| Kasahara, Shingo| Sano, Shunji| Oh, Hidemasa|
抄録 RATIONALE: Hypoplastic left heart syndrome (HLHS) remains a lethal congenital cardiac defect. Recent studies have suggested that intracoronary administration of autologous cardiosphere-derived cells (CDCs) may improve ventricular function. OBJECTIVE: The aim of this study was to test whether intracoronary delivery of CDCs is feasible and safe in patients with hypoplastic left heart syndrome. METHODS AND RESULTS: Between January 5, 2011, and January 16, 2012, 14 patients (1.8±1.5 years) were prospectively assigned to receive intracoronary infusion of autologous CDCs 33.4±8.1 days after staged procedures (n=7), followed by 7 controls with standard palliation alone. The primary end point was to assess the safety, and the secondary end point included the preliminary efficacy to verify the right ventricular ejection fraction improvements between baseline and 3 months. Manufacturing and intracoronary delivery of CDCs were feasible, and no serious adverse events were reported within the 18-month follow-up. Patients treated with CDCs showed right ventricular ejection fraction improvement from baseline to 3-month follow-up (46.9%±4.6% to 52.1%±2.4%; P=0.008). Compared with controls at 18 months, cardiac MRI analysis of CDC-treated patients showed a higher right ventricular ejection fraction (31.5%±6.8% versus 40.4%±7.6%; P=0.049), improved somatic growth (P=0.0005), reduced heart failure status (P=0.003), and lower incidence of coil occlusion for collaterals (P=0.007). CONCLUSIONS: Intracoronary infusion of autologous CDCs seems to be feasible and safe in children with hypoplastic left heart syndrome after staged surgery. Large phase 2 trials are warranted to examine the potential effects of cardiac function improvements and the long-term benefits of clinical outcomes.
キーワード cell therapy congenital heart disease hypoplastic left heart syndrome stem cells
備考 学位審査副論文
発行日 2015-02
出版物タイトル Circulation Research
116巻
4号
出版者 Lippincott Williams & Wilkins
開始ページ 653
終了ページ 664
ISSN 00097330
NCID AA00133553
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja
論文のバージョン author
PubMed ID 25403163
Web of Sience KeyUT 000349804900015
関連URL https://doi.org/10.1161/CIRCRESAHA.116.304671 http://ousar.lib.okayama-u.ac.jp/54044 http://ousar.lib.okayama-u.ac.jp/54263
フルテキストURL K0005439_other2.pdf
著者 Onoda, Satoshi| Kimata, Yoshihiro| Matsumoto, Kumiko| Yamada, Kiyoshi|
抄録 BACKGROUND: Lymphaticovenular anastomosis plays an important role in the surgical treatment of lymphedema. The outcomes of lymphaticovenular anastomosis are evaluated based on changes in edema; however, isolated assessment of the anastomosis itself is difficult. The authors used an animal experimental model to conduct a detailed examination of histologic changes associated with lymphaticovenular anastomosis and determined the factors important for success. METHODS: The experimental lymphaticovenular anastomosis model was created using lumbar lymph ducts and iliolumbar veins of Wistar rats. The authors performed anastomosis under a microscope and reviewed postoperative histologic changes using optical and electron microscopy. In addition, electron microscopy and histology were used for detailed examination of the area in the vicinity of the anastomotic region in cases with patency and obstruction. RESULTS: The patency rates immediately after, 1 week after, and 1 month after lymphaticovenular anastomosis were 100 percent (20 of 20), 70 percent (14 of 20), and 65 percent, respectively. A detailed examination of the anastomotic region with electron microscopy revealed that, in cases with patency, there was no notable transformation of the endothelial cells, which formed a smooth layer. In contrast, in obstruction cases, the corresponding region of the endothelium was irregular in structure. CONCLUSIONS: Vessel obstruction after lymphaticovenular anastomosis may be associated with irregular arrangement of the endothelial layer, leading to exposure of subendothelial tissues and platelet formation. One part of the postoperative changes after anastomosis and a cause of obstruction were elucidated in this study. The authors' results may enable improvements in lymphaticovenular anastomosis by translating back to real clinical operations.
備考 学位審査副論文
発行日 2016-01
出版物タイトル Plastic and Reconstructive Surgery
137巻
1号
出版者 Lippincott Williams & Wilkins
開始ページ 83e
終了ページ 91e
ISSN 00321052
NCID AA00775696
資料タイプ 学術雑誌論文
言語 English
OAI-PMH Set 岡山大学
著作権者 https://creativecommons.org/licenses/by-nc-nd/4.0/deed.ja
論文のバージョン author
PubMed ID 26710064
Web of Sience KeyUT 000367333300001
関連URL https://doi.org/10.1097/PRS.0000000000001884
著者 Asagi, Akinori| Ohta, Koji| Nasu, Junichirou| Tanada, Minoru| Nadano, Seijin| Nishimura, Rieko| Teramoto, Norihiro| Yamamoto, Kazuhide| Inoue, Takeshi| Iguchi, Haruo|
発行日 2013-01
出版物タイトル Pancreas
42巻
1号
資料タイプ 学術雑誌論文