Publications by authors named "Kunimoto H"

Anemia is a major clinical manifestation seen in myelodysplastic syndromes (MDS). Treatment options for anemia in low-risk MDS are limited. Especially, oral medication which is uniformly effective for anemia in low-risk MDS is required.

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Background: The cause of chronic thromboembolic pulmonary hypertension (CTEPH) remains largely unknown. Recently, clonal hematopoiesis (CH) has been reported to be associated with cardiovascular and thromboembolic diseases. Here, we investigated the prevalence and clinical impact of CH in patients with CTEPH.

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Objectives: Coronary flow reserve (CFR) is a strong predictor of cardiovascular events and prognosis in patients with coronary artery disease. This study aimed to evaluate preoperative factors associated with the unsuccessful restoration of CFR after coronary artery bypass grafting (CABG).

Methods: Included in this study were the 65 patients who presented with functionally significant left anterior descending artery (LAD) lesions confirmed by both fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR), and who underwent successful CABG at our hospital within the study period.

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Article Synopsis
  • - Erdheim-Chester disease (ECD) is a rare condition marked by the abnormal accumulation of histiocytes in various body systems, often leading to complications like pericardial effusion and thickening, resulting in potential heart issues.
  • - A case study is presented of a 51-year-old man with ECD who developed severe constrictive pericarditis, experiencing symptoms like fluid retention and heart failure.
  • - Following an accurate diagnosis, the patient was treated with interferon alpha, leading to significant improvements and emphasizing the need for early intervention for unexpected ECD complications.
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Aim: Short-term use of pemafibrate (PEM), a selective modulator of peroxisome proliferator-activated receptor alpha, has been reported to improve abnormal liver function in patients with nonalcoholic fatty liver disease with hypertriglyceridemia (HTG-NAFLD). This study aimed to clarify the effects and predictive factors of long-term 72-week PEM administration on body composition, and laboratory tests in HTG-NAFLD patients.

Methods: Fifty-three HTG-NAFLD patients receiving a 72-week PEM regimen were retrospectively enrolled.

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The epigenome regulates transcription of target genes through DNA methylation- or histone methylation/acetylation/phosphorylation/ubiquitination-mediated alteration of genomic function or chromatin conformation. Recent genomic studies have shown that multiple genes encoding epigenetic regulators are frequently and recurrently mutated in MDS, suggesting that epigenetic dysregulation is significantly associated with the molecular pathogenesis and clinical features of MDS. In this review, we will present our recent findings together with others, focusing on physiological molecular functions of epigenetic regulators recurrently mutated in MDS and on functional correlation between dysregulated epigenomic regulators and molecular pathogenesis/clinical features of MDS.

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Article Synopsis
  • VEXAS syndrome is a newly discovered autoinflammatory disease in adults caused by mutations in the UBA1 gene, leading to immune system activation and symptoms like fever and joint inflammation.
  • The syndrome is associated with blood disorders and specific blood cell changes, which can serve as indicators for diagnosing UBA1 mutations in symptomatic patients.
  • Treatment options are limited, but hematopoietic stem cell transplantation is the only potential cure, particularly for younger, healthier patients experiencing severe symptoms or complications.*
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Background: The site of arterial cannulation is an important consideration in the prevention of cerebral infarction after total arch replacement. We compared the outcomes of cannulation of the bilateral axillary artery, the femoral artery, and central cannulation in total arch replacement.

Methods: Enrolled were 242 patients, categorized into three groups according to the arterial cannulation site used: bilateral axillary artery group, 124 patients; femoral artery group, 88 patients; central cannulation group, 30 patients.

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VEXAS syndrome is a new disease entity characterized by the presence of cytoplasmic vacuoles in blood cells, X-linked autoinflammatory symptoms, and somatic variants in UBA1, which encodes an E1 ubiquitin-activating enzyme. Around 30-50% of VEXAS syndrome patients have concurrent MDS. We and others have recently analyzed clinical and genetic features of MDS associated with VEXAS syndrome and found that most of these cases are categorized in the low-risk subgroup with low bone marrow blast percentages.

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Background: Circulating autotaxin (ATX) levels have been reported to correlate with liver inflammation activity and liver fibrosis severity in patients with non-alcoholic fatty liver disease (NAFLD). The objective of this study is to investigate whether serum ATX could predict liver-related events (LRE) in NAFLD patients.

Methods: This retrospective investigation includes 309 biopsy-proven NAFLD patients registered at Shinshu University Hospital.

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Article Synopsis
  • Bloom syndrome (BS) is a rare genetic disease caused by changes in the BLM gene, which helps keep our genes stable and healthy.
  • People with BS have unique facial features, longer limbs, and skin problems like sensitivity to sunlight.
  • A 34-year-old woman with BS had a history of different cancers and passed away at 35; genetic tests showed she had two different harmful changes in the BLM gene.
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  • A phantom and analysis program were developed to assess the positional accuracy of Image-Guided Radiation Therapy (IGRT), with tests conducted across multiple facilities.
  • An end-to-end test was performed using an in-house phantom where images were taken after precise displacements, allowing comparison between calculated and actual target positions.
  • Results showed a maximum discrepancy of 0.24 mm with the in-house program and 0.30 mm with commercial software, confirming that the proposed method is practical for evaluating IGRT accuracy.
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  • * A CT number calibration audit phantom was scanned by 24 Japanese therapy institutes, and the resulting calibration curves were analyzed to assess their effectiveness compared to theoretical standards.
  • * The evaluation focused on mass density and relative electron density differences across various CT number calibration phantoms and TPSs, with particular attention to how Tomotherapy TPSs differed from other systems.
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Background: Serum C-reactive protein (CRP) is an established biomarker for acute inflammation and has been identified as a prognostic indicator for hepatocellular carcinoma (HCC). However, the significance of the serum CRP level, specifically in HCC patients treated with lenvatinib, remains unclear.

Methods: We retrospectively analyzed 125 HCC patients who received lenvatinib treatment at six centers.

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Purpose: Optimal strategy for transcatheter aortic valve implantation (TAVI) in patients with coronary artery disease (CAD) is unresolved. We evaluated the surgical outcomes of hybrid coronary artery bypass grafting (CABG) and TAVI in elderly patients.

Methods: We retrospectively evaluated patients who underwent simultaneous TAVI and CABG at Wakayama Medical University, Japan.

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Despite recent advances in the treatment of acute myeloid leukemia (AML), there has been limited success in targeting surface antigens in AML, in part due to shared expression across malignant and normal cells. Here, high-density immunophenotyping of AML coupled with proteogenomics identified unique expression of a variety of antigens, including the RNA helicase U5 snRNP200, on the surface of AML cells but not on normal hematopoietic precursors and skewed Fc receptor distribution in the AML immune microenvironment. Cell membrane localization of U5 snRNP200 was linked to surface expression of the Fcγ receptor IIIA (FcγIIIA, also known as CD32A) and correlated with expression of interferon-regulated immune response genes.

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O-linked N-acetylglucosamine transferase (OGT) critically regulates wide variety of biological processes such as gene expression, metabolism, stress response, signaling and proteostasis. In adult hematopoiesis, OGT is crucial for differentiation of B and T cells and the maintenance of hematopoietic stem cells (HSCs). However, a role for OGT in fetal liver (FL) hematopoiesis remains unknown.

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Purpose: Saphenous vein grafts (SVGs) sometimes occur as vein graft stenosis or failure in coronary artery bypass grafting. The purpose of this study was to detect the factors affecting vein graft atherosclerosis.

Methods: We performed two analysis.

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Background: Postoperative delirium in intensive care is common and associated with mortality, cognitive impairment, prolonged hospital stays and high costs. We evaluate whether a nurse-led orientation program could reduce the incidence of delirium in the intensive care unit after cardiovascular surgery.

Methods: In this retrospective cohort study, we enrolled patients admitted to the intensive care unit for planned cardiovascular surgery between January 2020 and December 2021.

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Background: Immune checkpoint inhibitors (ICIs) have been a breakthrough in cancer therapy. ICI therapy is generally better tolerated than cytotoxic chemotherapy; however, hematological adverse events (AEs) have not been fully analyzed. Hence, we performed a meta-analysis to evaluate the incidence and risk of ICI-related hematological AEs.

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Unlabelled: A 62-year-old male was admitted to our hospital with worsening dyspnea. Chest X-ray revealed dextrocardia, and echocardiography revealed decreased right ventricular function, a severely dilated tricuspid annulus, a massive tricuspid, and trivial mitral regurgitation. Patch augmentation of the tricuspid leaflet with auto-pericardium and ring annuloplasty with a flat-type upside-down artificial ring to fit the dextrocardia heart was performed.

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VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is a new disease entity with autoinflammatory disorders (AID) driven by somatic variants in UBA1 that frequently co-exists with myelodysplastic syndromes (MDS). Clinicopathological and molecular features of Japanese cases with VEXAS-associated MDS remain elusive. We previously reported high prevalence of UBA1 variants in Japanese patients with relapsing polychondritis, in which 5 cases co-occurred with MDS.

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Malignant peritoneal mesothelioma (MPeM) is a rare disease with a poor prognosis that develops in the mesothelial cells of the peritoneum. We encountered a 48-year-old man with no prior asbestos exposure who visited our hospital with abdominal pain. Laboratory findings showed elevated C-reactive protein of 15.

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Article Synopsis
  • Pemafibrate (PEM) shows promise as a treatment for hypertriglyceridemia linked to non-alcoholic fatty liver disease (HTG-NAFLD), with a study analyzing its effectiveness in 88 patients.
  • After 6 months of treatment, PEM led to significant reductions in liver enzymes, triglycerides, and total cholesterol without affecting body weight or composition.
  • The study identified that female patients with higher levels of liver enzymes (AST and ALT) and fat mass are more likely to respond positively to PEM therapy, suggesting these factors could be key predictors for treatment efficacy.
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Tumours or tumour-like lesions around the aortic valve are relatively rare and are difficult to diagnose. We report an interesting case of calcified thrombi in the Valsalva sinuses and coronary cusps that mimicked an aortic valve tumour. A 68-year-old man presented with a 20-mm calcified mass in the non-coronary and left-coronary cusps extending to their corresponding Valsalva sinuses, which was detected by echocardiography and contrast-enhanced computed tomography.

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