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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

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.


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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