Publications by authors named "Tomofumi Nakamura"

Exophiala dermatitidis (E. dermatitidis), which causes skin or respiratory disease, is occasionally fatal in immunocompromised patients. Here, we report the unique antifungal potency of terbinafine (TRB), which targets squalene epoxidase, against E.

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Background: Pulmonary vein isolation (PVI) with cryoballoon technology is a well-established therapy for treatment of atrial fibrillation (AF). Recently, a size-adjustable cryoballoon (POLARx FIT) that enables delivery in a standard 28-mm or an expanded 31-mm size was introduced.

Objective: The purpose of this study was to perform a randomized clinical trial to evaluate the safety and efficacy of this novel cryoballoon compared to the conventional cryoballoon.

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We report a patient with hemophilia A who underwent partial splenic embolization (PSE) for severe thrombocytopenia secondary to portal hypertension-induced splenomegaly, resulting in a stable long-term quality of life. The patient was diagnosed with hemophilia A and unfortunately contracted human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) from blood products. He subsequently developed progressive splenomegaly due to portal hypertension from chronic HCV, resulting in severe thrombocytopenia.

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Raltegravir (RAL), a human immunodeficiency virus (HIV)-1 integrase inhibitor, has been administered as part of antiretroviral therapy. Studies in patients with HIV-1 have shown high variability in the pharmacokinetics of RAL, and in healthy volunteers, coadministration of proton-pump inhibitors has been shown to increase the plasma RAL concentrations. Here, we found that RAL containing a 1,3,4-oxadiazole ring is converted to a hydrolysis product (H-RAL) with a cleaved 1,3,4-oxadiazole ring at pH 1.

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We report a patient with anorexia nervosa without bronchiectasis and cystic fibrosis who developed acute pneumonia caused by (). The black fungus found in multiple sputum cultures was determined to be using mass spectrometry and identified using genetic analysis. Although the initiation of antifungal therapy was late, the pneumonia gradually improved with long-term treatment.

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Background: We previously reported feasibility of irrigated needle ablation (INA) with a retractable 27-G end-hole needle catheter to treat nonendocardial ventricular arrhythmia substrate, an important cause of ablation failure.

Objectives: The purpose of this study was to report outcomes and complications in our entire INA-treated population.

Methods: Patients with recurrent sustained monomorphic ventricular tachycardia (VT) or high-density premature ventricular contractions (PVCs) despite radiofrequency ablation were prospectively enrolled at 4 centers.

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Background: Percutaneous coronary intervention (PCI) for calcified coronary artery remains challenging in the drug-eluting stent (DES) era. While recent studies reported the efficacy of orbital atherectomy (OA) combined with DES for calcified lesion, the effectiveness of drug-coated balloon (DCB) following OA has not been fully elucidated.

Methods: Between June 2018 and June 2021, 135 patients who received PCI for calcified de novo coronary lesions with OA were enrolled and divided into two groups; OA followed by DCB (n = 43) if the target lesion achieved acceptable preparation, or second- or third-generation DESs (n = 92) if the target lesion showed suboptimal preparation between June 2018 and June 2021.

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Background: The early diagnosis of necrotizing soft tissue infection (NSTI) caused by group A streptococcus (GAS) for performing debridement surgery is key to the patient survival. In 1996, the diversional use of a GAS-rapid antigen detection test (RADT) for pharyngitis was reported, quickly spreading as a clinically useful method. However, no clinical study has evaluated the reliability of RADT by using wound samples.

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Background: Brugada syndrome is a potential cause of sudden cardiac death (SCD) and is characterized by a distinct ECG, but not all patients with A Brugada ECG develop SCD. In this study we sought to examine if an artificial intelligence (AI) model can predict a previous or future ventricular fibrillation (VF) episode from a Brugada ECG.

Methods and results: We developed an AI-enabled algorithm using a convolutional neural network.

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Article Synopsis
  • The study examined how alcohol consumption affects the left atrial substrate and recurrence of atrial fibrillation (AF) after ablation in 110 patients without structural heart disease.
  • The results showed that while there were no significant differences in left atrial characteristics among abstainers, mild drinkers, and moderate-heavy drinkers, drinkers had a significantly lower success rate after a single ablation compared to abstainers (79.3% vs 95.9%).
  • Ultimately, the study concluded that alcohol consumption is linked to higher rates of AF recurrence post-ablation but does not notably change the atrial substrate itself.
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Article Synopsis
  • The study evaluated infusion needle ablation (INA) as a treatment for patients with frequent premature ventricular contractions (PVCs) resistant to standard ablation methods.
  • INA involved using a specialized catheter to deliver precise ablation directly into the heart muscle, achieving acute PVC elimination in 71.4% of patients.
  • After an average follow-up period, 73.3% of patients experienced a significant reduction in PVC burden, with a notable safety profile that included some minor complications.
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The development of artificial intelligence (AI) began in the mid-20th century but has been rapidly accelerating in the past decade. Reflecting the development of digital health over the past few years, this trend is also seen in medicine. The field of cardiovascular medicine uses a wide variety and a large amount of biosignals, so there are many situations where AI can contribute.

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Background: The efficacy of direct oral anticoagulants (DOACs) compared with warfarin for the treatment of venous thromboembolism (VTE), and the recurrence of VTE after discontinuation of anticoagulation therapy in research are limited.

Methods and results: This retrospective study enrolled 893 patients with acute VTE between 2011 and 2019. The cohort was divided into the transient risk, unprovoked, continued cancer treatment, and cancer remission groups.

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The human immunodeficiency virus type 1 (HIV-1) capsid (CA) is an essential viral component of HIV-1 infection and an attractive therapeutic target for antivirals. Here, we report that a small molecule, ACAi-028, inhibits HIV-1 replication by targeting a hydrophobic pocket in the N-terminal domain of CA (CA-NTD). ACAi-028 is 1 of more than 40 candidate anti-HIV-1 compounds identified by screening and 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assays.

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Mycotic aneurysms are sometimes seen in patients with infective endocarditis. We report a case of infective endocarditis with multiple mycotic aneurysms. Although antibiotics were effective, mycotic aneurysms appeared in the cerebral, hepatic, and gastroepiploic arteries.

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Background And Aims: The nutritional risk of patients who undergo atrial fibrillation (AF) ablation varies. Its impact on the recurrence after ablation is unclear. We sought to evaluate the relationship between the nutritional risk and arrhythmia recurrence in patients who undergo AF ablation.

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: This study aims to evaluate the efficacy and safety of direct oral anticoagulants (DOACs) after unfractionated heparin (UFH) bolus for the treatment of intermediate-high-risk pulmonary embolism. : On the basis of initial treatment, 81 patients were divided into two groups: DOAC after UFH bolus infusion group (group D; n=32) and conventional therapy group (group C; n=49). The frequency of recurrence of venous thromboembolism (VTE) and bleeding within 6 months were compared.

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An 80-year-old woman with acute posterolateralmyocardial infarction, cardiogenic shock, and acute heart failure was admitted to our hospital. Transthoracic echocardiography (TTE) showed dysfunction of the left ventricular inferolateral wall motion and severe mitral valve regurgitation (MR). Emergency coronary angiography revealed triple-vessel stenosis.

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Aims/introduction: The aim of the present study was to clarify the pathophysiologies of hyperglycemic crises in Japanese patients.

Materials And Methods: This was a retrospective study of patients with hyperglycemic crises admitted to Kumamoto Medical Center, Kumamoto, Japan, between 2012 and 2019. Patients were classified as having diabetic ketoacidosis (DKA), hyperglycemic hyperosmotic syndrome (HHS) or a mixed state of the two conditions (MIX), and laboratory data and levels of consciousness at hospital admission, as well as the rates of mortality and coagulation disorders, were compared.

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Background: Catheter ablation is a standard therapy for frequent premature ventricular complex (PVCs). Predicting their origin from a 12-lead electrocardiogram (ECG) is crucial but it requires specialized knowledge and experience.

Objective: The objective of the present study was to develop and evaluate machine learning algorithms that predicted PVC origins from an ECG.

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Objectives: This study sought to identify midmyocardial arrhythmogenic substrates by examining the frequency content of unipolar endocardial surface electrograms, comparing sites with transmural scar versus sites with intramural excitable substrate (IES) as identified during needle catheter ablation for ventricular tachycardia (VT).

Background: Midmyocardial arrhythmogenic substrates are a common reason catheter ablation for VT may fail.

Methods: A total of 659 intramural needle sites were studied in 26 patients (age 61 ± 9 years, 85% male, 69% nonischemic cardiomyopathy) who underwent intramural needle catheter ablation for VT.

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HIV-1 often acquires drug-resistant mutations in spite of the benefits of antiretroviral therapy (ART). HIV-1 integrase (IN) is essential for the concerted integration of HIV-1 DNA into the host genome. IN further contributes to HIV-1 RNA binding, which is required for HIV-1 maturation.

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Purpose: Current guidelines recommend complete extraction of cardiovascular implantable electronic devices (CIEDs) in the case of persistent or recurrent fungemia without other identifiable sources, though supporting evidence is lacking. We sought to evaluate the prognosis of patients with candidemia and CIEDs.

Methods: Twelve consecutive patients (54 ± 12 years, 8 male) with CIED and concurrent candidemia were reviewed.

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Background: Intramural substrate causing ventricular tachycardia can be targeted by radiofrequency (RF) infusion-needle catheter ablation.

Objective: The purpose of the study was to assess fluid distribution within the myocardium after needle-ablation catheter infusion and its evidence to RF lesion creation.

Methods: In 25 patients (21 (84%) male; 67 ± 9 years; 8 (32%) with ischemic cardiomyopathy) intramural ablation of ventricular tachycardia was performed with a needle catheter.

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