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Articles by Y Yoshiga
Total Records ( 2 ) for Y Yoshiga
  B Schmidt , A Metzner , K. R. J Chun , D Leftheriotis , Y Yoshiga , A Fuernkranz , K Neven , R. R Tilz , E Wissner , F Ouyang and K. H. Kuck
  Background—

Pulmonary vein isolation (PVI) is an established treatment option for patients with drug refractory paroxysmal atrial fibrillation. A novel compliant endoscopic ablation system housing a 980-nm-diode laser allows for discrete point-by-point ablation enabling a true circumferential ablation line design. We sought to determine the feasibility and safety of a circumferential ablation using endoscopic ablation system.

Methods and Results—

Thirty patients (17 female; mean age, 58±9 years) with a median paroxysmal atrial fibrillation history of 3 years (range, 1 to 17 years) were treated. PVI was achieved in 114 of 116 (98%) PVs (4 left common PVs), thereby achieving simultaneous PVI for separate ipsilateral PVs in 19 of 26 (73%) left PVs and 6 of 30 (20%) right PVs. The total procedure time was 250±62 minutes. Procedure time decreased from 310±59 to 220±37 minutes (P=0.0001) between the first 10 and the last 20 cases. Mean fluoroscopy time was 30±18 minutes. Twenty-seven patients underwent postoperative endoscopy showing no or minimal thermal lesions in the esophagus in 21 (78%) and 2 (7%), respectively. In 4 (15%) patients, an esophageal ulceration was found that healed without sequelae. One pericardial tamponade and 1 right-sided phrenic nerve palsy occurred. During a median follow-up of 168 days (113 to 203 days; q1-q3), 24 of 30 patients (80%) remained free of atrial fibrillation recurrence.

Conclusions—

Circumferential PVI using the novel compliant endoscopic ablation system was feasible in the majority of left PVs and minority of right PVs accompanied by a complication rate comparable to established approaches. To minimize the risk for thermal esophageal injury temperature monitoring is recommended.

  T Tashiro , E Sekine Kondo , T Shigeura , R Nakagawa , S Inoue , M Omori Miyake , T Chiba , N Hongo , S. i Fujii , K Shimizu , Y Yoshiga , T Sumida , K Mori , H Watarai and M. Taniguchi
 

NKT cells are characterized by their production of both Th1 and Th2 cytokines immediately after stimulation with -galactosylceramide (-GalCer), which is composed of -galactopyranose linked to ceramide (itself composed of sphingosine and fatty-acyl chains); the chain length of the ceramide varies and this affects the ability of -GalCer to stimulate cytokine production. However, the contribution of its galactopyranose sugar moiety remains unclear. We synthesized -carba-GalCer, which has an -linked carba-galactosyl moiety; here, the 5a'-oxygen atom of the D-galactopyranose ring of -GalCer is replaced by a methylene group. The -carba-GalCer was more stable and showed higher affinity to the NKT receptor. It thus enhanced and prolonged production of IL-12 and IFN- compared with -GalCer, resulting in augmented NKT cell-mediated adjuvant effects in vivo. The -carba-GalCer, which has an ether linkage, was more resistant to degradation by liver microsomes than was -GalCer, which has an acetal bond. Modulation of the sugar moiety in glycolipids might therefore provide optimal therapeutic reagents for protective immune responses against tumor or pathogens.

 
 
 
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