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Atsuhiko Sato

Publications and source records attributed to Atsuhiko Sato.

10 recordsLinked to original sources

Easy pulmonary vein isolation using epicardial cryoablation.

The maze procedure can be accomplished by several techniques with varying degrees of success. These techniques include cut-and-sew, endocardial cryoablation, and epicardial ablation using heat-producing devices. We describe our surgical modification of pulmonary vein isolation with cryoablation using an epicardial and endocardial approach. This simple and reliable technique, which does not need any special device, will assist in mitral valve surgery for patients with chronic atrial fibrillation.

Aged↗

Pulmonary artery aneurysm with ascending aortic aneurysm concomitant with bilateral bicuspid semilunar valves.

Aneurysm of both the pulmonary trunk and the ascending aorta concomitant with bilateral bicuspid valves is very rare. The reason for the formation of aneurysm with bicuspid semilunar valve is still inconclusive. Surgical repair was performed successfully (ie, aortic valve replacement, graft replacement for the ascending aorta, and plication of the pulmonary artery). Pathology of the pulmonary artery wall did not demonstrate cystic medial necrosis. The hemodynamic turbulence by the bilateral bicuspid valve may cause the formation of aneurysms even at low pressure. This case demonstrates an explanation for aneurysm with the bicuspid valve.

Aneurysm↗

Infective endocarditis associated with Sjogren's syndrome.

Sjögren's syndrome is one of the major autoimmune diseases, however infective endocarditis associated with Sjögren's syndrome has not previously been reported. A patient with Sjögren's syndrome associated with aortic valve regurgitation due to infective endocarditis, underwent successful aortic valve replacement. Patients with Sjögren's syndrome tend to be at a higher risk of intraoral infections due to diminished secretion of saliva. Particular care must be taken of Sjögren's syndrome patients as they can also be at an increased risk of infective endocarditis.

Adult↗

Double-blind, placebo-controlled trial of pirfenidone in patients with idiopathic pulmonary fibrosis.

Idiopathic pulmonary fibrosis (IPF) is a fatal disorder without an effective therapy to date. In a double-blind, randomized, placebo-controlled trial, 107 patients were prospectively evaluated for efficacy of a novel compound, pirfenidone. The difference in the change in the lowest oxygen saturation by pulse oximetry (SpO2) during a 6-minute exercise test, the primary endpoint, from baseline to 6 months was not significant between the two groups (p = 0.0722). In a prespecified subset of patients who maintained a SpO2 greater than 80% during a 6-minute exercise test at baseline, the lowest SpO2 improved during a 6-minute exercise test in the pirfenidone group at 6 and 9 months (p = 0.0069 and 0.0305, respectively). Positive treatment effect was demonstrated in secondary endpoints: (1) change in VC measurements at 9 months (p = 0.0366) and (2) episodes of acute exacerbation of IPF occurring exclusively in the placebo group during the 9 months (p = 0.0031). Significant adverse events were associated with pirfenidone; however, adherence to treatment regimen was similar between pirfenidone and placebo groups. In conclusion, treatment with pirfenidone improved VC and prevented acute exacerbation of IPF during the 9 months of follow-up. Future long-term studies are needed to clarify the overall safety and efficacy of pirfenidone in IPF.

Aged↗

Hospital and mid-term outcomes in elderly patients under-going off-pump coronary artery bypass grafting--comparison with younger patients--.

BACKGROUND: Clinical outcomes and problems following off-pump coronary artery bypass grafting (OPCAB) in elderly patients have not been clarified. METHODS AND RESULTS: The surgical results of elderly patients aged 75 years or older (n=50; 38 males, mean age, 78.8 years) were reviewed and compared with those of younger patients (n=95; 79 males, mean age, 63.0 years). The EuroSCORE score was 6.9+/-3.5 in the elderly group and 3.0+/-2.4 in the younger group (p<0.0001). There were no hospital deaths in either group. There was no significant difference in the postoperative complication rate except for atrial fibrillation (40.0% elderly vs 24.2% younger, p=0.0479). Postoperative intensive care unit and hospital stays did not differ. The frequency of blood transfusion was significantly higher in the elderly group (78.0% elderly vs 37.2% younger, p<0.0001). During the mean follow-up of 18.6+/-8.8 months, there was 1 sudden death in the elderly group, but no cardiac deaths in either group. The 32-month cardiac event-free and survival rates were similar for the 2 groups. CONCLUSION: OPCAB provides satisfactory clinical outcomes for elderly as well as younger patients.

Aged↗

Effects of suplatast tosilate on cytokine profile of bronchoalveolar cells in allergic inflammation of the lung.

OBJECTIVE: Suplatast tosilate is an anti-allergic agent that inhibits IgE antibody production. It appears to have an inhibitory effect on the production of Th2 cytokines (interleukin (IL)-4, IL-5) in vitro. In the present study, we investigated the effects of suplatast on eosinophil infiltration and cytokine mRNA expression in bronchoalveolar lavage (BAL) fluid in a Brown Norway (BN) rat model of bronchial asthma. METHODOLOGY: Suplatast (50 mg/kg per day) was administered intraperitoneally for 15 consecutive days to 8-week-old male BN rats that had been actively sensitized to ovalbumin (OA) and alum and rats were challenged with OA aerosol to induce allergic bronchial inflammation. The control group was examined 48 h after antigen inhalation to measure the cell count and cell fraction in BAL fluid. Reverse transcription-polymerase chain reaction using primers for IL-4, IL-5, interferon (IFN)-gamma and beta-actin was used to semiquantitatively measure mRNA expression in BAL cells 24 h after antigen inhalation. RESULTS: Suplatast was found to decrease the total cell count and the eosinophil count. The mean total cell count in BAL in the suplatast-treated group was 18.8 x 10(5) and the mean eosinophil count was 7.8 x 10(5) compared with 73.0 x 10(5) and 48.9 x 10(5), respectively, in the control group. Suplatast also suppressed expression of IL-4 and IL-5 mRNA in BAL cells. However, there were no significant changes in IFN-gamma expression. CONCLUSIONS: Suplatast was found to have an inhibitory effect on eosinophil infiltration in a rat model of bronchial asthma. It also appeared to inhibit allergic inflammation by altering the cytokine profile.

Analysis of Variance↗

Clinicopathological features of chronic hypersensitivity pneumonitis.

OBJECTIVE: Only limited information exists concerning the clinical and pathological features of chronic hypersensitivity pneumonitis (HP) in Japan and elsewhere. We present data on clinicopathological features of chronic HP obtained through a Japanese nationwide survey. METHODOLOGY: We studied the clinical and pathological findings in 10 patients with chronic HP who underwent surgical lung biopsy or postmortem examination. RESULTS: There were three types of clinical course: six of the 10 patients had persistent symptoms followed by repeated acute episodes; two showed a subacute onset with persistent symptoms; and two exhibited an insidious onset. Five patients made no attempt to avoid antigen exposure and they all had progressive disease. Pathological findings indicated that lesions were mainly centrilobular with or without epithelioid cell granulomas in specimens obtained during the acute or subacute stage. In contrast, most patients in the chronic stage predominantly showed interstitial fibrosis with a usual interstitial pneumonia pattern. CONCLUSIONS: The pathological findings of chronic HP depend on the stage of the disease at tissue sampling.

Aged↗