start-ver=1.4 cd-journal=joma no-vol=69 cd-vols= no-issue=3 article-no= start-page=183 end-page=188 dt-received= dt-revised= dt-accepted= dt-pub-year=2015 dt-pub=201506 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Pure Choriocarcinoma of the Ovary in Silver-Russell Syndrome en-subtitle= kn-subtitle= en-abstract= kn-abstract=Pure ovarian choriocarcinoma is an extremely rare malignancy that can be gestational or non-gestational in origin. Silver-Russell syndrome (SRS) is a rare congenital developmental disorder characterized by pre- and postnatal growth failure, relative macrocephaly, a triangular face, hemihypotrophy, and fifth-finger clinodactyly. We report a rare case of pure ovarian choriocarcinoma occurring in a 19-year-old woman with SRS. Following surgery, multiple chemotherapy courses were effective and she was free of disease at the 10-month follow-up. en-copyright= kn-copyright= en-aut-name=HarumaTomoko en-aut-sei=Haruma en-aut-mei=Tomoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=OgawaChikako en-aut-sei=Ogawa en-aut-mei=Chikako kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NishidaTakeshi en-aut-sei=Nishida en-aut-mei=Takeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KusumotoTomoyuki en-aut-sei=Kusumoto en-aut-mei=Tomoyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=NakamuraKeiichiro en-aut-sei=Nakamura en-aut-mei=Keiichiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SekiNoriko en-aut-sei=Seki en-aut-mei=Noriko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KatayamaTakaaki en-aut-sei=Katayama en-aut-mei=Takaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=HiramatsuYuji en-aut-sei=Hiramatsu en-aut-mei=Yuji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil= kn-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=6 en-affil= kn-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=7 en-affil= kn-affil=Department of Obstetrics and Gynecology, Himeji St Mary?s Hospital affil-num=8 en-affil= kn-affil=Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=choriocarcinoma kn-keyword=choriocarcinoma en-keyword=ovary kn-keyword=ovary en-keyword=Silver-Russell syndrome kn-keyword=Silver-Russell syndrome END start-ver=1.4 cd-journal=joma no-vol=69 cd-vols= no-issue=3 article-no= start-page=177 end-page=182 dt-received= dt-revised= dt-accepted= dt-pub-year=2015 dt-pub=201506 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Maxillary Advancement for Unilateral Crossbite in a Patient with Sleep Apnea Syndrome en-subtitle= kn-subtitle= en-abstract= kn-abstract=This article reports the case of a 44-year-old male with skeletal Class III, Angle Class III malocclusion and unilateral crossbite with concerns about obstructive sleep apnea syndrome (OSAS), esthetics and functional problems. To correct the skeletal deformities, the maxilla was anteriorly repositioned by employing LeFort I osteotomy following pre-surgical orthodontic treatment, because a mandibular setback might induce disordered breathing and cause OSAS. After active treatment for 13 months, satisfactory occlusion was achieved and an acceptable facial and oral profile was obtained. In addition, the apnea hypopnea index (AHI) decreased from 18.8 preoperatively to 10.6 postoperatively. Furthermore, after a follow-up period of 7 months, the AHI again significantly decreased from 10.6 to 6.2. In conclusion, surgical advancement of the maxilla using LeFort I osteotomy has proven to be useful in patients with this kind of skeletal malocclusion, while preventing a worsening of the OSAS. en-copyright= kn-copyright= en-aut-name=HoshijimaMitsuhiro en-aut-sei=Hoshijima en-aut-mei=Mitsuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=HonjoTadashi en-aut-sei=Honjo en-aut-mei=Tadashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MoritaniNorifumi en-aut-sei=Moritani en-aut-mei=Norifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=IidaSeiji en-aut-sei=Iida en-aut-mei=Seiji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=YamashiroTakashi en-aut-sei=Yamashiro en-aut-mei=Takashi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=KamiokaHiroshi en-aut-sei=Kamioka en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= affil-num=1 en-affil= kn-affil=Departments of Orthodontics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Oral and Maxillofacial Surgery, Tottori University Faculty of Medicine affil-num=3 en-affil= kn-affil=Departments of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine affil-num=4 en-affil= kn-affil=Departments of Oral and Maxillofacial Reconstructive Surgery, Okayama University Graduate School of Medicine affil-num=5 en-affil= kn-affil=Department of Orthodontics and Dentofacial Orthopedics, Graduate School of Dentistry, Osaka University affil-num=6 en-affil= kn-affil=Departments of Orthodontics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=LeFort I osteotomy kn-keyword=LeFort I osteotomy en-keyword=maxillary advancement kn-keyword=maxillary advancement en-keyword=unilateral crossbite kn-keyword=unilateral crossbite en-keyword=obstructive sleep apnea syndrome kn-keyword=obstructive sleep apnea syndrome END start-ver=1.4 cd-journal=joma no-vol=69 cd-vols= no-issue=3 article-no= start-page=173 end-page=176 dt-received= dt-revised= dt-accepted= dt-pub-year=2015 dt-pub=201506 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Prone-Position Thoracoscopic Ligation of the Thoracic Duct for Chyle Leak Following Radical Neck Dissection in a Patient with a Right Aortic Arch en-subtitle= kn-subtitle= en-abstract= kn-abstract=A chyle leak can occur as a complication after neck or chest surgery. Such a leak prolongs the hospital stay and is sometimes life-threatening. The treatment options are conservative management, interventional radiologic embolization, and surgery. Thoracoscopic ligation of the thoracic duct has emerged as a promising and definitive treatment. The case of a 65-year-old Japanese male patient with a rare congenital right aortic arch (type‡VB1 of Edward?s classification) and a severe chyle leak that occurred after a total pharyngolaryngo-esophagectomy (TPLE) is described. The chyle leak was successfully managed by thoracoscopic ligation of the thoracic duct via a left-side approach with the patient in the prone position. en-copyright= kn-copyright= en-aut-name=ShirakawaYasuhiro en-aut-sei=Shirakawa en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NomaKazuhiro en-aut-sei=Noma en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=OharaToshiaki en-aut-sei=Ohara en-aut-mei=Toshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=KashimaHajime en-aut-sei=Kashima en-aut-mei=Hajime kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=MaedaNaoaki en-aut-sei=Maeda en-aut-mei=Naoaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=TanabeShunsuke en-aut-sei=Tanabe en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=KagawaShunsuke en-aut-sei=Kagawa en-aut-mei=Shunsuke kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=FujiwaraToshiyoshi en-aut-sei=Fujiwara en-aut-mei=Toshiyoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil= kn-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=2 en-affil= kn-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=3 en-affil= kn-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=4 en-affil= kn-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=5 en-affil= kn-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=6 en-affil= kn-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=7 en-affil= kn-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences affil-num=8 en-affil= kn-affil=Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences en-keyword=chyle leak kn-keyword=chyle leak en-keyword=thoracic duct kn-keyword=thoracic duct en-keyword=thoracoscopy kn-keyword=thoracoscopy en-keyword=prone position kn-keyword=prone position END start-ver=1.4 cd-journal=joma no-vol=69 cd-vols= no-issue=3 article-no= start-page=165 end-page=171 dt-received= dt-revised= dt-accepted= dt-pub-year=2015 dt-pub=201506 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Dynamic Finite Element Analysis of Impulsive Stress Waves Propagating from the Greater Trochanter of the Femur by a Sideways Fall en-subtitle= kn-subtitle= en-abstract= kn-abstract=Fall accidents are a common cause of femoral fracture in the elderly. The greater trochanter of the femur is often subjected to impact loading by a sideways fall, and thus it is worth studying the impulsive stress waves propagating in the femur. In this study, the impulsive stress was analyzed by the dynamic finite element method using a 3-dimensional model of the femur, and the influence of the fall configuration on the stress was discussed. The stress was concentrated around the femoral neck during the propagation of the stress wave, and the tensile maximum principal stress changed into compressive minimum principle stress on the anterior and medial sides of the neck. On the other hand, the compressive minimum principal stress changed into tensile maximum principle stress on the lateral side of the neck. The largest maximum principal stress during the impact loading was always larger in the neck than in the impact region. The largest absolute value of the minimum principal stress was found in the neck or the impact region depending on the fall configuration. The largest absolute values of the maximum and minimum principal stress were nearly equal, indicating that the bone fracture due to the tensile stress may occur around the femoral neck. en-copyright= kn-copyright= en-aut-name=SaraiTakaaki en-aut-sei=Sarai en-aut-mei=Takaaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=TokumotoAkihiro en-aut-sei=Tokumoto en-aut-mei=Akihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= affil-num=1 en-affil= kn-affil=Division of Industrial Innovation Sciences, Graduate School of Natural Science and Technology, Okayama University affil-num=2 en-affil= kn-affil=Fujikura Co., Ltd. en-keyword=biomechanics kn-keyword=biomechanics en-keyword=sideways fall kn-keyword=sideways fall en-keyword=femoral neck kn-keyword=femoral neck en-keyword=greater trochanter kn-keyword=greater trochanter en-keyword=impulsive stress wave kn-keyword=impulsive stress wave END start-ver=1.4 cd-journal=joma no-vol=69 cd-vols= no-issue=3 article-no= start-page=155 end-page=163 dt-received= dt-revised= dt-accepted= dt-pub-year=2015 dt-pub=201506 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Eosinophil Cationic Protein Shows Survival Effect on H9c2 Cardiac Myoblast Cells with Enhanced Phosphorylation of ERK and Akt/GSK-3ƒĄ under Oxidative Stress en-subtitle= kn-subtitle= en-abstract= kn-abstract=To assess the knowledge and attitudes of pregnant Japanese women regarding non-invasive prenatal testing (NIPT). Between March and June 2013, 557 pregnant women in the Hyogo and Hiroshima Prefectures were surveyed using an anonymous, self-completed questionnaire. A total of 91.9µ respondents (512/557) stated that they gagreeh or gconditionally agreeh with NIPT implementation in Japan. Approximately 28.5µ of respondents stated that they knew that the accuracy of a positive NIPT result can be affected by mother?s age and background, while 34.5µ of respondents stated that it was necessary for pregnant women with a positive result to undergo fetal chromosome diagnosis using amniocentesis;both percentages were low. Additionally, 92.3µ of respondents would glike a detailed explanation of the test,h 65.1µ of them would glike psychological support if the NIPT test results came back positive,h and 5.7µ would terminate the pregnancy if the NIPT test results came back positive without undergoing fetal chromosome diagnosis via amniocentesis. Although a high proportion of pregnant Japanese women agreed with the introduction of NIPT into Japanese obstetrical care, there was insufficient knowledge regarding the test. It is necessary for women undergoing NIPT to be provided sufficient information and psychological support. en-copyright= kn-copyright= en-aut-name=MikamoShoko en-aut-sei=Mikamo en-aut-mei=Shoko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NakatsukaMikiya en-aut-sei=Nakatsuka en-aut-mei=Mikiya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= affil-num=1 en-affil= kn-affil=Graduate School of Health Sciences, Okayama University affil-num=2 en-affil= kn-affil=Graduate School of Health Sciences, Okayama University en-keyword=amniocentesis kn-keyword=amniocentesis en-keyword=Down syndrome kn-keyword=Down syndrome en-keyword=fetal chromosome diagnosis kn-keyword=fetal chromosome diagnosis en-keyword=non-invasive prenatal testing kn-keyword=non-invasive prenatal testing en-keyword=psychological support kn-keyword=psychological support END start-ver=1.4 cd-journal=joma no-vol=69 cd-vols= no-issue=3 article-no= start-page=145 end-page=153 dt-received= dt-revised= dt-accepted= dt-pub-year=2015 dt-pub=201506 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Eosinophil Cationic Protein Shows Survival Effect on H9c2 Cardiac Myoblast Cells with Enhanced Phosphorylation of ERK and Akt/GSK-3ƒĄ under Oxidative Stress en-subtitle= kn-subtitle= en-abstract= kn-abstract=Eosinophil cationic protein (ECP) is well known as a cationic protein contained in the basic granules of activated eosinophils. Recent studies have reported that ECP exhibits novel activities on various types of cells, including rat neonatal cardiomyocytes. Here we evaluated the effects of ECP on rat cardiac myoblast H9c2 cells. Our results showed that ECP enhanced the survival of the cells, in part by promoting the ERK and Akt/GSK-3ƒĄ signaling pathways. ECP attenuated the cytotoxic effects of H2O2 on H9c2 cells as well as the production of reactive oxygen species, the number of apoptotic cells and caspase 3/7 activity in the cells. In conclusion, ECP activated the ERK and Akt/GSK-3ƒĄ pathways, resulting in anti-oxidative effects on H9c2 cells that attenuated apoptosis. en-copyright= kn-copyright= en-aut-name=IshiiHiroko en-aut-sei=Ishii en-aut-mei=Hiroko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=KamikawaShigeshi en-aut-sei=Kamikawa en-aut-mei=Shigeshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=HirohataSatoshi en-aut-sei=Hirohata en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MizutaniAkifumi en-aut-sei=Mizutani en-aut-mei=Akifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=AbeKoji en-aut-sei=Abe en-aut-mei=Koji kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=SenoMasaharu en-aut-sei=Seno en-aut-mei=Masaharu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OohashiToshitaka en-aut-sei=Oohashi en-aut-mei=Toshitaka kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=NinomiyaYoshifumi en-aut-sei=Ninomiya en-aut-mei=Yoshifumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= affil-num=1 en-affil= kn-affil=Departments of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine affil-num=2 en-affil= kn-affil=Departments of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine affil-num=3 en-affil= kn-affil=Departments of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine affil-num=4 en-affil= kn-affil=Department of Chemistry and Biotechnology, Graduate School of Natural Science and Technology, Okayama University affil-num=5 en-affil= kn-affil=Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, affil-num=6 en-affil= kn-affil=Department of Chemistry and Biotechnology, Graduate School of Natural Science and Technology, Okayama University affil-num=7 en-affil= kn-affil=Departments of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine affil-num=8 en-affil= kn-affil=Departments of Molecular Biology and Biochemistry, Okayama University Graduate School of Medicine en-keyword=ECP kn-keyword=ECP en-keyword=reactive oxygen species kn-keyword=reactive oxygen species en-keyword=Akt kn-keyword=Akt en-keyword=ERK kn-keyword=ERK END start-ver=1.4 cd-journal=joma no-vol=69 cd-vols= no-issue=3 article-no= start-page=137 end-page=144 dt-received= dt-revised= dt-accepted= dt-pub-year=2015 dt-pub=201506 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Aberrant Expression of Keratin 7 in Hepatocytes as a Predictive Marker of Rapid Progression to Hepatic Failure in Asymptomatic Primary Biliary Cirrhosis en-subtitle= kn-subtitle= en-abstract= kn-abstract=A predictive marker of the rapid progression to hepatic failure is desired for patients with asymptomatic primary biliary cirrhosis (aPBC). We performed a systematic cohort analysis of 101 patients diagnosed as having aPBC and the rapid progression to liver failure in some, by focusing on cholestasis. Cholestasis was assessed by aberrant keratin7 (K-7) expressions in the patients? hepatocytes. Intralobular expressions of K-7 were found in 9 of the 101 patients. The grades of K-7 expression were significantly associated with the levels of alanine aminotransferase, alkaline phosphatase, and total bilirubin at the time of diagnosis, but not with bile duct loss or cholestasis. Stepwise logistic regression analysis revealed that high grades of K-7 expression correlated positively with high levels of total bilirubin. During the follow-up period, 8 patients developed jaundice, and the mean period until the development of jaundice was 5.2 years. The proportional hazards models for the risk of developing jaundice identified a high grade of aberrant K-7 expression in hepatocytes as the only significant risk factor. Aberrant K-7 expression in hepatocytes can be used as an additional marker to predict rapid progression to liver failure in patients with aPBC at the time of diagnosis. en-copyright= kn-copyright= en-aut-name=SekiHiroyuki en-aut-sei=Seki en-aut-mei=Hiroyuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=IkedaFusao en-aut-sei=Ikeda en-aut-mei=Fusao kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=NanbaShintaro en-aut-sei=Nanba en-aut-mei=Shintaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=MoritouYuki en-aut-sei=Moritou en-aut-mei=Yuki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=TakeuchiYasuto en-aut-sei=Takeuchi en-aut-mei=Yasuto kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=YasunakaTetsuya en-aut-sei=Yasunaka en-aut-mei=Tetsuya kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=OnishiHideki en-aut-sei=Onishi en-aut-mei=Hideki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= en-aut-name=MiyakeYasuhiro en-aut-sei=Miyake en-aut-mei=Yasuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=8 ORCID= en-aut-name=TakakiAkinobu en-aut-sei=Takaki en-aut-mei=Akinobu kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=9 ORCID= en-aut-name=NousoKazuhiro en-aut-sei=Nouso en-aut-mei=Kazuhiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=10 ORCID= en-aut-name=IwasakiYoshiaki en-aut-sei=Iwasaki en-aut-mei=Yoshiaki kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=11 ORCID= en-aut-name=NakamuraMinoru en-aut-sei=Nakamura en-aut-mei=Minoru kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=12 ORCID= en-aut-name=YamamotoKazuhide en-aut-sei=Yamamoto en-aut-mei=Kazuhide kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=13 ORCID= affil-num=1 en-affil= kn-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, affil-num=2 en-affil= kn-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, affil-num=3 en-affil= kn-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, affil-num=4 en-affil= kn-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, affil-num=5 en-affil= kn-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, affil-num=6 en-affil= kn-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, affil-num=7 en-affil= kn-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, affil-num=8 en-affil= kn-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, affil-num=9 en-affil= kn-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, affil-num=10 en-affil= kn-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, affil-num=11 en-affil= kn-affil=Health Service Center, Okayama University affil-num=12 en-affil= kn-affil=Clinical Research Center, National Hospital Organization Nagasaki Medical Center affil-num=13 en-affil= kn-affil=Departments of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, en-keyword=primary biliary cirrhosis kn-keyword=primary biliary cirrhosis en-keyword=keratin 7 kn-keyword=keratin 7 en-keyword=hepatic failure kn-keyword=hepatic failure END start-ver=1.4 cd-journal=joma no-vol=69 cd-vols= no-issue=3 article-no= start-page=129 end-page=136 dt-received= dt-revised= dt-accepted= dt-pub-year=2015 dt-pub=201506 dt-online= en-article= kn-article= en-subject= kn-subject= en-title= kn-title=Epoprostenol Therapy for Pulmonary Arterial Hypertension en-subtitle= kn-subtitle= en-abstract= kn-abstract=Pulmonary arterial hypertension (PAH) is characterized by elevation of pulmonary artery pressure caused by pulmonary vasoconstriction and vascular remodeling, which leads to right heart failure and death. Epoprostenol (prostaglandin I2) has a potent short-acting vasodilator property, and intravenous continuous epoprostenol is therefore used for treatment of PAH. Here we review evidence for the usefulness of intravenous continuous epoprostenol therapy in patients with PAH. Epoprostenol therapy is effective in idiopathic PAH patients and in patients with PAH associated with connective tissue disease, portal hypertension or congenital heart diseases, but it is not effective in patients with pulmonary veno-occlusive disease or pulmonary capillary hemangiomatosis. High-dose epoprostenol therapy markedly improved hemodynamics in some patients with PAH, possibly due to reverse remodeling of pulmonary arteries. This therapy has several side effects and complications such as headache, hypotension and catheter-related infections. Intravenous continuous epoprostenol is an effective treatment, but there are still some problems to be resolved. en-copyright= kn-copyright= en-aut-name=AkagiSatoshi en-aut-sei=Akagi en-aut-mei=Satoshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=1 ORCID= en-aut-name=NakamuraKazufumi en-aut-sei=Nakamura en-aut-mei=Kazufumi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=2 ORCID= en-aut-name=MatsubaraHiromi en-aut-sei=Matsubara en-aut-mei=Hiromi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=3 ORCID= en-aut-name=OgawaAiko en-aut-sei=Ogawa en-aut-mei=Aiko kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=4 ORCID= en-aut-name=SarashinaToshihiro en-aut-sei=Sarashina en-aut-mei=Toshihiro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=5 ORCID= en-aut-name=EjiriKentaro en-aut-sei=Ejiri en-aut-mei=Kentaro kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=6 ORCID= en-aut-name=ItoHiroshi en-aut-sei=Ito en-aut-mei=Hiroshi kn-aut-name= kn-aut-sei= kn-aut-mei= aut-affil-num=7 ORCID= affil-num=1 en-affil= kn-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine affil-num=2 en-affil= kn-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine affil-num=3 en-affil= kn-affil=Department of Clinical Science, National Hospital Organization Okayama Medical Center affil-num=4 en-affil= kn-affil=Department of Clinical Science, National Hospital Organization Okayama Medical Center affil-num=5 en-affil= kn-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine affil-num=6 en-affil= kn-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine affil-num=7 en-affil= kn-affil=Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine en-keyword=pulmonary arterial hypertension kn-keyword=pulmonary arterial hypertension en-keyword=epoprostenol kn-keyword=epoprostenol en-keyword=high-dose kn-keyword=high-dose en-keyword=complications kn-keyword=complications en-keyword=side effects kn-keyword=side effects END