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Biomedical subjects

J Kaneko

Publications and source records attributed to J Kaneko.

At least 19 recordsLinked to original sources
PubMed2006

16q-linked autosomal dominant cerebellar ataxia: a clinical and genetic study.

The autosomal dominant cerebellar ataxias (ADCAs) comprise a genetically and clinically heterogenous group of neurodegenerative disorders. Very recently, a C-to-T single nucleotide substitution in the puratrophin-1 gene was found to be strongly associated with a form of ADCA linked to chromosome 16q22.1 (16q-linked ADCA; OMIM 600223). We found the C-to-T substitution in the puratrophin-1 gene in 20 patients with ataxia (16 heterozygotes and four homozygotes) and four asymptomatic carriers in 9 of 24 families with an unknown type of ADCA. We also found two cases with 16q-linked ADCA among 43 sporadic patients with late-onset cortical cerebellar atrophy (LCCA). The mean age at onset in the 22 patients was 61.8 years, and that of homozygous patients was lower than that of heterozygous ones in one family. Neurological examination revealed that the majority of our patients showed exaggerated deep tendon reflexes in addition to the cardinal symptom of cerebellar ataxia (100%), and 37.5% of them had sensorineural hearing impairment, whereas sensory axonal neuropathy was absent. The frequency of 16q-linked ADCA was about 1/10 of our series of 110 ADCA families, making it the third most frequent ADCA in Japan.

Age of Onset↗
PubMed2006

Preoperative estimation of right lateral sector graft by three-dimensional computed tomography.

The right lateral sector is an alternative graft for living donor liver transplantation. Three-dimensional image reconstruction of right lateral sector grafts was performed to reveal vascular anatomy and volume using three-dimensional computed tomography software in three donors. There was a correlation between actual and estimated volume (r=.93), although actual graft volume tended to be larger than the preoperative estimated volume. In one donor, a portal branch of the right lateral sector was independently ramified. The branch was sacrificed in the operation because its territory volume was only 44 cm3. Three-dimensional images matched the shape of the right lateral sector graft. Three-dimensional computed tomography might be useful before donor hepatectomy, providing important information for decisions regarding the operative procedure.

Humans↗
PubMed2006

Impact of celiac axis stenosis on living donor hepatectomy.

BACKGROUND: Celiac axis stenosis was once cited as a reason for exclusion from living donor liver transplantation. Donor hepatectomy, however, leaves the pancreaticoduodenal artery arcade untouched, and theoretically, celiac axis stenosis has no impact on otherwise possible donors. METHODS: Among 350 consecutive adult living donors of liver transplantation at Tokyo University Hospital, we experienced 11 (3%) donors with celiac axis stenosis or occlusion due to the median arcuate ligament. RESULTS: Harvesting of the right liver was the most common procedure (n = 8), followed by harvesting of segments II and III (n = 2), and left liver (n = 1). The postoperative course was uneventful in all of the donors. CONCLUSIONS: Our results indicate that donor hepatectomy can be safely performed in the presence of significant celiac artery stenosis.

Adult↗
PubMed2006

New-onset diabetes mellitus after living donor liver transplantation: possible association with hepatitis C.

BACKGROUND: The relationship between hepatitis C virus (HCV) infection and new-onset diabetes mellitus (NODM) after liver transplantation is a controversial issue. METHODS: A total of 223 adult living donor liver transplantation (LDLT) recipients followed for more than 6 months were analyzed for the prevalence of NODM. The prevalence was compared between 62 HCV-positive and 161 HCV-negative patients. All the HCV-positive patients underwent preemptive antiviral treatment with interferon alpha2b and ribavirin. RESULTS: Preoperative diabetes mellitus was more frequently observed in HCV-positive patients (18% vs 4%, P = .001). NODM occurred more frequently in HCV-positive patients (41% vs 22%, P = .003). Multivariate analysis, however, revealed that HCV was not a predictor for NODM. A comparison of 14 HCV-positive patients with persistent NODM and 48 patients without persistent NODM indicated that there was no significant difference in the frequency of the viral response to antiviral therapy nor in HCV-RNA levels. Impaired glucose tolerance did not impact postoperative survival after LDLT. CONCLUSIONS: HCV was not associated with the prevalence of NODM after LDLT. NODM did not influence patient survival.

Adult↗
PubMed2005

Relation between the middle hepatic vein drainage area volume and alanine aminotransferease after left liver harvesting.

Complete outflow is impossible to maintain on both sides in donors undergoing hemiliver graft harvesting, because the middle hepatic vein (MHV) can be preserved on only one side. The area in which outflow veins are disrupted becomes congested and does not sufficiently regenerate. The relation between changes in alanine aminotransferase (ALT) and the congestive area volume of the congestive area is unknown. The 64 subjects presented herein were living donors who provided the left liver with the caudate lobe and MHV trunk. The midpoint between the tributaries of the MHV and the right hepatic vein was determined preoperatively using computed tomography. The midpoint between the tributaries of the MHV and right hepatic vein and the borderline between the right and left liver were used to predict the MHV drainage area volume. ALT was measured in donors on postoperative days 1, 3, 5, 7, 10, and 14. The patients were divided into three groups according to the ratio of calculated MHV drainage area volume in the remnant right liver: less than 15% (n = 21, group A); greater than 15% and less than 20% (n = 18, group B); greater than 20% (n = 25, group C). There were significant differences in the ALT levels between groups (P = .004). MHV drainage area volume, calculated using the present method, was associated with high ALT levels after left liver harvesting with the MHV. The present study suggests that persistently high ALT levels are associated with the volume of the interrupted MHV drainage area.

Alanine Transaminase↗
PubMed2005

Cryptococcosis after living donor liver transplantation: report of three cases.

Cryptococcosis is the third most common invasive fungal infection in solid organ transplantation, which usually occurs more than 6 months after the primary operation. In our series of 180 consecutive adult living-donor liver transplantation recipients, three (1.5%) had cryptococcosis and one of these patients died. The serum cryptococcal antigen examination was positive in all three patients who suffered from cryptococcosis. The serum cryptococcal antigen test might contribute to the early detection and treatment of cryptococcosis.

Aged↗
PubMed2004

Prediction of hepatic artery thrombosis by protocol Doppler ultrasonography in pediatric living donor liver transplantation.

Hepatic arterial thrombosis (HAT) after liver transplantation is a life-threatening event. Previous reports have suggested that the resistive index (RI) of the hepatic artery predicts HAT. Doppler ultrasonography (US) to measure RI, however, is not routinely performed. The subjects were 70 pediatric patients who underwent living donor liver transplantation (LDLT). Protocol Doppler US was performed once or twice a day for 2 weeks postoperatively and 692 records were examined. Changes in RI values were examined separately in patients with and without HAT complications. The incidence of HAT was 10% (seven of 70). HAT was diagnosed an average of 6.2 days after LDLT. In patients without HAT complications ( n = 63), average RI levels at 14 days after LDLT were 0.71 +/- 0.1 (records, n = 625). In patients with HAT complications, RI decreased gradually within 2 days before the onset of HAT. RI values of less than 0.6 predicted HAT within 2 days before onset, with 83% sensitivity and 85% specificity. RI during the first 2 weeks after LDLT is a sensitive predictor for HAT. Thrombectomy and reanastomosis should be considered when RI values are less than 0.6 in Doppler US.

Adolescent↗
PubMed2004

Living donor liver transplantation for end-stage hepatitis C.

Living donor liver transplantation is important for patients with end-stage viral hepatitis because of the shortage of organs from deceased donors. However, preliminary results indicate that living liver donation might be disadvantageous for hepatitis C virus-positive patients. Twenty-seven patients who underwent living donor liver transplantation for hepatitis C virus cirrhosis preemptively received antiviral therapy using interferon-alpha2b and ribavirin, which was started an average of 32 days after the operation and continued for at least 6 months thereafter. The serum hepatitis C virus RNA became negative in the 8 of 16 patients with more than 1 year follow-up. The cumulative 3-year patient survival was 85%, which was comparable to that of hepatitis C virus negative patients (n = 93; 90%). Preemptive antiviral therapy after transplantation may be necessary for satisfactory results after living donor liver transplantation.

Adult↗
PubMed2004

Classification of portal vein anatomy for partial liver transplantation.

The anatomy of the portal vein is usually classified as 3 to 5 patterns and simple compared with the anatomy of the hepatic artery. The variety of portal vein anatomy was examined in 287 living donors for liver transplantation. More than 90% of donors showed a normal bifurcation type; 6% showed the trifurcation type. Only 3% displayed a separate origin of the right paramedian and the right lateral branches. There was no anomalous pattern that had not been reported previously. In our series, we conclude that it is rare for 2 or more stumps of portal vein to appear in partial liver transplantation. The frequency is much less if the left liver or the right lateral liver graft is used for adult-to-adult living donor liver transplantation.

Functional Laterality↗
PubMed2004

Simultaneous hepatic artery and portal vein thrombosis after living donor liver transplantation.

Simultaneous hepatic artery and portal vein thrombosis rarely occurs after liver transplantation. The etiology is unknown. Of 213 patients (72 children and 141 adults) that underwent living donor liver transplantation (LDLT) from January 1996 to March 2003, 4 (2%) developed simultaneous thrombosis at 3 hours to 7 days (median, 4 days) after the operation. Emergent thrombectomy was performed in three patients; the remaining patient was registered in the Japan organ transplant network. All of the patients died due to hepatic failure (range, 18 hours to 6 days after the diagnosis; median, 2 days). Portal vein, hepatic artery, and hepatic vein velocity in the liver graft were measured every 12 hours by Doppler ultrasonography for 2 weeks after liver transplantation. These parameters were stable until just before the simultaneous thrombosis. These findings indicate that protocol Doppler ultrasonography can diagnose, but not predict, this fatal complication.

Adolescent↗
PubMed2004

Conversion to cyclosporine provides valuable rescue therapy for living donor adult liver transplant patients intolerant to tacrolimus: A single-center experience at the University of Tokyo.

Tacrolimus-based immunosuppression is currently accepted as mainstream therapy in many transplant centers worldwide due to its potent immunosuppressive activity compared to cyclosporine. A tacrolimus-based regimen has been successfully used for our living donor liver transplantation (LDLT) recipients. Adverse effects such as neurotoxicity, nephrotoxicity, and new-onset diabetes mellitus, however, have limited its clinical application. In deceased donor liver transplantation, cyclosporine rescue therapy is valuable for such complications, but few reports have described a strategy for conversion in LDLT. Herein, we present our experience of conversion from tacrolimus to cyclosporine therapy in adult LDLT recipients. Among 203 recipients, 37 patients (18%) required conversion, primarily for neurotoxicity (41%), diabetes mellitus (16%), hematopoietic disorder (16%), and gastrointestinal intolerance (11%). Primary adverse events resolved within 2 months after conversion in 35/37 (94%) of the patients. For LDLT recipients unable to maintain effective immunosuppression with tacrolimus, conversion to cyclosporine is an effective option.

Adult↗
PubMed2003

Observation of B0 -->D0K0 and B0 -->D0K*0 decays.

We report on a search for B(0)-->D(*0)K(*0) decays based on 85 x 10(6) BB events collected with the Belle detector at KEKB. The B(0)-->D0K(0) and B(0)-->D0K(*0) decays have been observed for the first time with the branching fractions B(B(0)-->D0K(0))=(5.0(+1.3)(-1.2)+/-0.6)x10(-5) and B(B(0)-->D0K(*0))=(4.8(+1.1)(-1.0)+/-0.5)x10(-5). No significant signal has been found for the B(0)-->D(*0)K*0) and B(0)-->D(*0)K(*0) decay modes, and upper limits at 90% C.L. are presented.

Journal Article↗
PubMed2003

Measurement of the electroweak penguin process B-->X(s)l+l-.

We report the first measurement of the branching fraction for the inclusive decay B-->X(s)l(+)l(-), where l is either an electron or a muon, and X(s) is a hadronic recoil system that contains an s quark. We analyzed a data sample of 65.4 x 10(6) B meson pairs collected with the Belle detector at the KEKB e(+)e(-) asymmetric-energy collider. We find B(B-->X(s)l(+)l(-))=[6.1 +/-1.4(stat) +1.4-1.1(syst)] x 10(-6) for dilepton masses greater than 0.2 GeV/c(2).

Journal Article↗
PubMed2003

Duct-to-duct biliary reconstruction for living donor liver transplantation: experience of 92 cases.

Bile duct-to duct reconstruction is now performed in living donor liver transplantation (LDLT) for adult patients. To confirm the feasibility, the results after the reconstruction were retrospectively analyzed. The subjects were 92 adult patients who underwent LDLT at the University of Tokyo Hospital. During the observation period (median 546 days), biliary complications were observed in 28 cases (30%). The complications included bile juice leakage in 11, stenosis at the anastomotic site in 9, and tube trouble in 8. Of these, 20 patients required surgical revision. The results suggest that duct-to-duct reconstruction provides satisfactory results, although long-term observation will be necessary.

Bile Ducts↗
PubMed2003

Left liver grafts for patients with MELD score of less than 15.

Left liver grafts are now seldom used for adult recipients of living donor liver transplantations because the left liver is believed to be insufficient to meet patient metabolic demands. At the University of Tokyo Hospital, left liver grafts have been limited to patients with fulminant hepatic failure or chronic hepatic failure with a model for end-stage liver disease (MELD) score of less than 15. Since 2000 25 adult patients received left liver grafts. The mean graft weight to standard liver volume ratio was 44%. The rates of acute rejection, vascular, and biliary complications were 24%, 0%, and 25%, respectively. All patients survived the operation and are doing well with a mean follow-up of 17 months. The present results suggest that left liver grafts provide acceptable results among patients satisfying our criteria.

Adult↗
PubMed2002

Observation of D+(s)K- and evidence for D+(s)pi- final states in neutral B decays.

We report the first observation of a B meson decay that is not accessible by a direct spectator process. The channel B(0)-->D(+)(s)K- is found in a sample of 85 x 10(6) BB; events, collected with the Belle detector at KEKB, with a branching fraction B(B(0)-->D(+)(s)K-)=(4.6(+1.2)(-1.1)+/-1.3) x 10(-5). We also obtain evidence for the B0-->D(+)(s)pi(-) decay with branching fraction B(B0-->D(+)(s)pi(-))=(2.4(+1.0)(-0.8)+/-0.7) x 10(-5). This value may be used to extract a model-dependent value of |V(ub)|.

Journal Article↗
PubMed2002

Observation of B(0)-->D((*)0)pp.

The B meson decay modes B-->Dpp; and B-->D(*)pp; have been studied using 29.4 fb(-1) of data collected with the Belle detector at KEKB. The B;(0)-->D(0)pp; and B;(0)-->D(*0)pp; decays have been observed for the first time with branching fractions B(B;(0)-->D(0)pp;)=(1.18+/-0.15+/-0.16)x10(-4) and B(B;(0)-->D(*0)pp;)=(1.20(+0.33)(-0.29)+/-0.21)x10(-4). No signal has been found for the B+-->D(+)pp; and B+-->D(*+)pp; decay modes, and the corresponding upper limits at 90% C.L. are presented.

Journal Article↗