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Kobayashi Y, Satou Y, Kon T, Tanioka D, Shimizu K, Mizutani T. STMO-12 Efforts for safe malignant brain tumor surgery at our hospital. Neurooncol Adv 2021. [PMCID: PMC8648245 DOI: 10.1093/noajnl/vdab159.048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Although maximal safe resection is the current standard for glioblastoma surgery, its safety and removal rate conflict with each other. Electrophysiological monitoring, such as motor evoked potential monitoring and awake craniotomy, can be utilized as safety measures; not all facilities can perform them. Herein, we present a representative case report on our efforts for a safe malignant brain tumor surgery. Case: A 77-year-old woman with glioblastoma in the premotor cortex presented with seizure of the upper left lower limb. Her pyramidal tract ran from the medial bottom to the posterior of the tumor. We performed excision from the site using the lowest gamma entropy. We then removed all parts of the tumor, with the exception of the pyramidal tract infiltration, and no paralysis was observed. She was definitively diagnosed with glioblastoma and is currently on maintenance chemotherapy. As a preoperative examination, we performed cerebrovascular angiography. We then performed various other tests to ascertain the patient’s condition. Considering lesions that affect language, Wada tests were performed regardless of laterality. For all patients with epilepsy onset, preoperative 256-channel electroencephalogram measurement and intraoperative the gamma entropy analysis were performed to confirm epileptogenicity. Considering lesions that affect eloquence, subdural electrodes were placed and brain function mapping was performed the next day. Based on the results, the safest cortical incision site and excision range were determined, and excision was performed on the following day. Of the 14 operated glioblastoma cases after November 2018, more than 85% of the contrast-enhanced lesions were completely removed in 7 cases, partially removed in 5 cases, and underwent biopsy in 2 cases. Postoperative Karnofsky performance status scores remained unchanged in 11 cases, improved in 1 case, and deteriorated in 2 cases. Our efforts have resulted in safe and sufficient removal of malignant brain tumors during surgery.
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Affiliation(s)
- Yusuke Kobayashi
- Department of neurosurgery, Showa University School of Medicine, Tokyo, Japan
| | - Yosuke Satou
- Department of neurosurgery, Showa University School of Medicine, Tokyo, Japan
| | - Takashi Kon
- Department of neurosurgery, Showa University School of Medicine, Tokyo, Japan
| | - Daisuke Tanioka
- Department of neurosurgery, Showa University School of Medicine, Tokyo, Japan
| | - Katsuyoshi Shimizu
- Department of neurosurgery, Showa University School of Medicine, Tokyo, Japan
| | - Tohru Mizutani
- Department of neurosurgery, Showa University School of Medicine, Tokyo, Japan
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102
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Yoshino T, Oshima S, Sugitani T, Kobayashi Y, Kawakami K, Kodama K, Onuma H, Yasumoto H, Shiina H, Hasegawa Y. Impact of visceral obesity on operative outcomes of laparoscopic nephrectomy: comparison between visceral fat area and body mass index. Afr J Urol 2021. [DOI: 10.1186/s12301-021-00164-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Obesity has been considered as a risk factor influencing operative difficulty. It was reported that body mass index (BMI; kg/m2) did not always properly reflect the degree of a patient’s visceral fat. The purpose of this study is to retrospectively investigate the association of operative outcomes and obesity indices including visceral fat area (VFA; cm2) and BMI in retroperitoneoscopic nephrectomy (RN).
Methods
We retrospectively reviewed consecutive 96 RN procedures performed from September 2016 to June 2020. We divided patients into BMI obese group (BMI ≥ 25, n = 25) and BMI normal group (BMI < 25, n = 71), VFA obese group (VFA ≥ 100, n = 54) and VFA normal group (VFA < 100, n = 42). Patient characteristics, operative and postoperative outcomes were compared between the two groups for each index of obesity.
Results
In two groups divided by BMI, the only specimen weight was significantly greater in the obese group (320 vs. 460 g, p < 0.001), whereas VFA obese group had longer insufflation time (165 vs. 182 min, p = 0.028), greater estimated blood loss (34 vs. 88 ml, p = 0.003) and greater specimen weight (255 vs. 437 g, p < 0.001) than VFA normal group. In a logistic regression analysis, high VFA value was a significant predictor for greater specimen weight and high VFA value and large size of renal tumor were significant predictors for greater blood loss. By contrast, BMI was not a significant predictor. Furthermore, in the case of non-obese patients (BMI < 25), VFA obese group had significantly longer insufflation time, greater estimated blood loss and greater specimen weight than normal group.
Conclusions
The present data suggest that VFA is a more useful parameter than BMI for predicting the operative difficulty associated with obesity, and VFA has a higher use value in non-obese patients (BMI < 25) than in obese patients (BMI ≥ 25).
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103
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Matoba Y, Tsuji K, Morisada T, Takahashi M, Kobayashi Y, Nakamura M, Banno K, Aoki D. Massive Hemorrhage Due to Cervical Endometriotic Cyst Rupture: Two Case Reports and a Literature Review. Am J Case Rep 2021; 22:e934120. [PMID: 34818313 PMCID: PMC8630560 DOI: 10.12659/ajcr.934120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Endometriosis is defined as the growth of ectopic endometrial tissue beyond the uterine cavity, and endometriosis on the uterine cervix is a rare variant. Although asymptomatic patients with cervical endometriosis or those with minor symptoms are treated conservatively, there are reports of life-threatening hemorrhage due to cervical endometriosis. Here, we report 2 cases of massive genital bleeding caused by cervical endometriotic cysts and we performed a literature review. CASE REPORT Case 1: A 32-year-old woman presented to our hospital due to massive genital bleeding on her 11th day of menstruation. An arterial hemorrhage in a cervical endometriotic cyst was suspected. As pressure hemostasis proved difficult, urgent uterine artery embolization (UAE) by interventional radiology was performed. Angiography during the UAE showed extravascular leakage from the branch of the left uterine artery. After embolization, hemostasis was achieved. No further genital bleeding was observed, and transvaginal ultrasound showed the cyst has continued to shrink for 9 months after the UAE with sequential dienogest, a progesterone receptor agonist, treatment. Case 2: A 43-year-old woman presented to our hospital with increasing massive genital bleeding after completing a 12-day course of 0.5 mg of norgestrel and 0.05 mg of ethinyl estradiol as a treatment for irregular intermenstrual bleeding. We suspected cervical endometriotic cyst rupture on imaging and performed an urgent laparoscopic total hysterectomy. In the excised uterine specimen, a cystic lesion that contained old, blood-like fluid was macroscopically observed in the cervix and was diagnosed pathologically as endometriosis. CONCLUSIONS Cervical endometriotic cyst rupture is rare; however, it should be kept in mind as a differential diagnosis when treating massive genital bleeding because urgent intervention is sometimes required to control the bleeding.
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Affiliation(s)
- Yusuke Matoba
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Kosuke Tsuji
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Tohru Morisada
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Mio Takahashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Yusuke Kobayashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Masaru Nakamura
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Kouji Banno
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku, Tokyo, Japan
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104
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Takeda T, Tsuji K, Kobayashi Y, Banno K, Aoki D. Clinical and pathological analysis of companion diagnostic testing of microsatellite instability-high for pembrolizumab in gynaecologic malignancy. Jpn J Clin Oncol 2021; 52:128-133. [PMID: 34750611 DOI: 10.1093/jjco/hyab175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 10/02/2021] [Accepted: 10/25/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Microsatellite instability-high is a known biomarker for anti-PD-1/PD-L1 immune checkpoint therapy. It is also a known tumour feature of Lynch syndrome, detected most frequently in endometrial cancer. However, it remains unclear how microsatellite instability testing is carried out in the clinical field. METHODS Ninety-nine patients with gynaecological malignant tumours who underwent microsatellite instability testing as a companion diagnosis for pembrolizumab and 16 patients who previously underwent microsatellite instability testing as a screening for Lynch syndrome were recruited. Clinical information, microsatellite instability status, outcomes, genetic assessments and information about cancer tissue were retrospectively analysed. RESULTS Ninety-nine patients had 101 gynaecologic malignant tumours including 26 endometrial, 38 ovarian and 28 cervical cancers, 9 with other tumours including 2 synchronous endometrial and ovarian cancers. All tissue samples were successfully tested, even though some were ≥10-year-old samples. Three cases (3.0%, 3/99) showed microsatellite instability-high; all cases were endometrial cancers with one case of synchronous endometrial and ovarian cancer [11.5% (3/26) in endometrial cancer, 2.6% (1/38) in ovarian cancer], and there was no microsatellite instability-high in cervical and other cancers. One of the endometrial cancer patients received pembrolizumab treatment, but finally died of cancer. Two other cases underwent genetic testing; both were diagnosed as Lynch syndrome. Six cases (37.5%) showed microsatellite instability-high in screening for Lynch syndrome. CONCLUSIONS Microsatellite instability-high was less commonly detected as a companion diagnosis for pembrolizumab in unselected gynaecologic patients. Genetic counselling should be always provided along with treatment selection.
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Affiliation(s)
| | | | - Yusuke Kobayashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Kouji Banno
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
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105
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Imaeda K, Kobayashi Y, Nakamura K, Hayashi S, Morisada T, Banno K, Aoki D. Usefulness of Endoscopy for Female Genital Plastic Surgery: A Series of 4 Cases with Genital Malformations. Am J Case Rep 2021; 22:e934363. [PMID: 34743169 PMCID: PMC8588711 DOI: 10.12659/ajcr.934363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Case series
Patients: Female, 18-year-old • Female, 25-year-old • Female, 12-year-old • Female, 29-year-old
Final Diagnosis: Mayer-Rokitansky-Kuster-Hauser syndrome • OHVIRA syndrome • Wunderlich syndrome
Symptoms: Excessive menstruation • irregular menstruation • lower abdominal pain • primary amenorrhea
Medication: —
Clinical Procedure: —
Specialty: Obstetrics and Gynecology
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Affiliation(s)
- Keiyo Imaeda
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Yusuke Kobayashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Kanako Nakamura
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Shigenori Hayashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Tohru Morisada
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Kouji Banno
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
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106
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Ono R, Kajiyama T, Takaoka H, Kobayashi Y. Austrian syndrome associated with mitral paravalvular pneumococcal abscess. QJM 2021; 114:529-530. [PMID: 33769546 DOI: 10.1093/qjmed/hcab064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- R Ono
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 260-8670, Japan
| | - T Kajiyama
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 260-8670, Japan
| | - H Takaoka
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 260-8670, Japan
| | - Y Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-Ku, Chiba 260-8670, Japan
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107
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Onozuka D, Tanoue Y, Nomura S, Kawashima T, Yoneoka D, Eguchi A, Ng CFS, Matsuura K, Shi S, Makiyama K, Uryu S, Kawamura Y, Takayanagi S, Gilmour S, Hayashi TI, Miyata H, Sera F, Sunagawa T, Takahashi T, Tsuchihashi Y, Kobayashi Y, Arima Y, Kanou K, Suzuki M, Hashizume M. Reduced mortality during the COVID-19 outbreak in Japan, 2020: a two-stage interrupted time-series design. Int J Epidemiol 2021; 51:75-84. [PMID: 34718594 PMCID: PMC8856001 DOI: 10.1093/ije/dyab216] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/15/2021] [Indexed: 01/08/2023] Open
Abstract
Background Coronavirus disease 2019 (COVID-19) continues to be a major global health burden. This study aims to estimate the all-cause excess mortality occurring in the COVID-19 outbreak in Japan, 2020, by sex and age group. Methods Daily time series of mortality for the period January 2015–December 2020 in all 47 prefectures of Japan were obtained from the Ministry of Health, Labour and Welfare, Japan. A two-stage interrupted time-series design was used to calculate excess mortality. In the first stage, we estimated excess mortality by prefecture using quasi-Poisson regression models in combination with distributed lag non-linear models, adjusting for seasonal and long-term variations, weather conditions and influenza activity. In the second stage, we used a random-effects multivariate meta-analysis to synthesize prefecture-specific estimates at the nationwide level. Results In 2020, we estimated an all-cause excess mortality of −20 982 deaths [95% empirical confidence intervals (eCI): −38 367 to −5472] in Japan, which corresponded to a percentage excess of −1.7% (95% eCI: −3.1 to −0.5) relative to the expected value. Reduced deaths were observed for both sexes and in all age groups except those aged <60 and 70–79 years. Conclusions All-cause mortality during the COVID-19 outbreak in Japan in 2020 was decreased compared with a historical baseline. Further evaluation of cause-specific excess mortality is warranted.
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Affiliation(s)
- Daisuke Onozuka
- Department of Medical Informatics and Clinical Epidemiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yuta Tanoue
- Institute for Business and Finance, Waseda University, Tokyo, Japan.,Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Shuhei Nomura
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takayuki Kawashima
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.,Department of Mathematical and Computing Science, Tokyo Institute of Technology, Tokyo, Japan
| | - Daisuke Yoneoka
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.,Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Akifumi Eguchi
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.,Department of Sustainable Health Science, Center for Preventive Medical Sciences, Chiba University, Chiba, Japan
| | - Chris Fook Sheng Ng
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Kentaro Matsuura
- Department of Management Science, Graduate School of Engineering, Tokyo University of Science, Tokyo, Japan.,HOXO-M Inc., Tokyo, Japan
| | - Shoi Shi
- Department of Systems Pharmacology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Laboratory for Synthetic Biology, RIKEN Center for Biosystems Dynamics Research, Osaka, Japan
| | | | - Shinya Uryu
- Center for Environmental Biology and Ecosystem Studies, National Institute for Environmental Studies (NIES), Tokyo, Japan
| | - Yumi Kawamura
- RIKEN Center for Sustainable Resource Science, Saitama, Japan
| | | | - Stuart Gilmour
- Graduate School of Public Health, St. Luke's International University, Tokyo, Japan
| | - Takehiko I Hayashi
- Center for Health and Environmental Risk Research, National Institute for Environmental Studies, Ibaraki, Japan
| | - Hiroaki Miyata
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Francesco Sera
- Department of Statistics, Computer Science and Applications 'G. Parenti', University of Florence, Florence, Italy
| | - Tomimasa Sunagawa
- Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, Tokyo, Japan
| | - Takuri Takahashi
- Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, Tokyo, Japan
| | - Yuuki Tsuchihashi
- Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, Tokyo, Japan
| | - Yusuke Kobayashi
- Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, Tokyo, Japan
| | - Yuzo Arima
- Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazuhiko Kanou
- Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, Tokyo, Japan
| | - Motoi Suzuki
- Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, Tokyo, Japan
| | - Masahiro Hashizume
- Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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108
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Matoba Y, Banno K, Kobayashi Y, Yamagami W, Nakamura M, Kisu I, Aoki D. Hysteroscopic treatment assisted by photodynamic diagnosis for atypical polypoid adenomyoma: A report of two cases. Photodiagnosis Photodyn Ther 2021; 36:102583. [PMID: 34673272 DOI: 10.1016/j.pdpdt.2021.102583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/27/2021] [Accepted: 10/12/2021] [Indexed: 10/20/2022]
Abstract
Atypical polypoid adenomyoma (APA) is an intrauterine tumor for which hysteroscopic tumor resection allows for fertility preservation. Complete resection is important because of the high recurrence rate of APA, but is difficult due to the lack of characteristic hysteroscopic findings. We previously reported a case in which photodynamic diagnosis (PDD) was useful for detection of APA. Here, we report two additional cases of APA treated by hysteroscopic resection with PDD. The procedure was approved by the ethical committee. Case 1: A 35-year-old female who underwent hysteroscopic surgery for a submucosal tumor suspected to be APA with hypermenorrhea. Case 2: A 37-year-old female in whom hysteroscopic surgery was performed for a residual APA lesion after hormone therapy. In Case 1, PDD identified the tumor borders and this enabled as complete resection as possible. In Case 2, lesions could not be identified clearly under white light, but some areas were PDD-positive and were excised. Among 19 specimens from these two cases and the previously reported case, all PDD-positive specimens were pathologically diagnosed as APA. The sensitivity and specificity of PDD for APA were 76.9% and 100%, respectively. These results suggest that PDD can contribute to identification of APA.
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Affiliation(s)
- Yusuke Matoba
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-0016, Japan
| | - Kouji Banno
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-0016, Japan.
| | - Yusuke Kobayashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-0016, Japan
| | - Wataru Yamagami
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-0016, Japan
| | - Masaru Nakamura
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-0016, Japan
| | - Iori Kisu
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-0016, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-0016, Japan
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109
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Boulay F, Simpson GS, Ichikawa Y, Kisyov S, Bucurescu D, Takamine A, Ahn DS, Asahi K, Baba H, Balabanski DL, Egami T, Fujita T, Fukuda N, Funayama C, Furukawa T, Georgiev G, Gladkov A, Hass M, Imamura K, Inabe N, Ishibashi Y, Kawaguchi T, Kawamura T, Kim W, Kobayashi Y, Kojima S, Kusoglu A, Lozeva R, Momiyama S, Mukul I, Niikura M, Nishibata H, Nishizaka T, Odahara A, Ohtomo Y, Ralet D, Sato T, Shimizu Y, Sumikama T, Suzuki H, Takeda H, Tao LC, Togano Y, Tominaga D, Ueno H, Yamazaki H, Yang XF, Daugas JM. Boulay et al. Reply. Phys Rev Lett 2021; 127:169202. [PMID: 34723612 DOI: 10.1103/physrevlett.127.169202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/31/2021] [Indexed: 06/13/2023]
Affiliation(s)
- F Boulay
- CEA, DAM, DIF, 91297 Arpajon cedex, France
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- GANIL, CEA/DSM-CNRS/IN2P3, BP55027, 14076 Caen cedex 5, France
| | - G S Simpson
- LPSC, CNRS/IN2P3, Université Joseph Fourier Grenoble 1, INPG, 38026 Grenoble Cedex, France
| | - Y Ichikawa
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - S Kisyov
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 077125 Bucharest-Măgurele, Romania
| | - D Bucurescu
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 077125 Bucharest-Măgurele, Romania
| | - A Takamine
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D S Ahn
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Asahi
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - H Baba
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D L Balabanski
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Extreme Light Infrastructure-Nuclear Physics (ELI-NP), Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 077125 Bucharest-Măgurele, Romania
| | - T Egami
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Advanced Sciences, Hosei University, 3-7-2 Kajino-cho, Koganei, Tokyo 184-8584, Japan
| | - T Fujita
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Osaka University, Machikaneyama 1-1 Toyonaka, Osaka 560-0034, Japan
| | - N Fukuda
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - C Funayama
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - T Furukawa
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Metropolitan University, 1-1 Minami-Ohsawa, Hachioji, Tokyo 192-0397, Japan
| | - G Georgiev
- CSNSM, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay Campus, France
| | - A Gladkov
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu 702-701, South Korea
| | - M Hass
- Department of Particle Physics, Weizmann Institute of Science, Rehovot 76100, Israel
| | - K Imamura
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Meiji University, 1-1-1 Higashi-Mita, Tama, Kawasaki, Kanagawa 214-8571, Japan
| | - N Inabe
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Y Ishibashi
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-5877, Japan
| | - T Kawaguchi
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Advanced Sciences, Hosei University, 3-7-2 Kajino-cho, Koganei, Tokyo 184-8584, Japan
| | - T Kawamura
- Department of Physics, Osaka University, Machikaneyama 1-1 Toyonaka, Osaka 560-0034, Japan
| | - W Kim
- Department of Physics, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu 702-701, South Korea
| | - Y Kobayashi
- Department of Informatics and Engineering, University of Electro-Communication, 1-5-1 Chofugaoka, Chohu, Tokyo 182-8585, Japan
| | - S Kojima
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - A Kusoglu
- CSNSM, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay Campus, France
- Department of Physics, Faculty of Science, Istanbul University, Vezneciler/Faith, 34134 Istanbul, Turkey
| | - R Lozeva
- CSNSM, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay Campus, France
| | - S Momiyama
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - I Mukul
- Department of Particle Physics, Weizmann Institute of Science, Rehovot 76100, Israel
| | - M Niikura
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - H Nishibata
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Osaka University, Machikaneyama 1-1 Toyonaka, Osaka 560-0034, Japan
| | - T Nishizaka
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Advanced Sciences, Hosei University, 3-7-2 Kajino-cho, Koganei, Tokyo 184-8584, Japan
| | - A Odahara
- Department of Physics, Osaka University, Machikaneyama 1-1 Toyonaka, Osaka 560-0034, Japan
| | - Y Ohtomo
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - D Ralet
- CSNSM, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay Campus, France
| | - T Sato
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - Y Shimizu
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Sumikama
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Suzuki
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Takeda
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - L C Tao
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University, Beijing 100871, China
| | - Y Togano
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - D Tominaga
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Advanced Sciences, Hosei University, 3-7-2 Kajino-cho, Koganei, Tokyo 184-8584, Japan
| | - H Ueno
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Yamazaki
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - X F Yang
- Instituut voor Kern-en Stralingsfysica, K.U. Leuven, Celestijnenlaan 200D, 3001 Leuven, Belgium
| | - J M Daugas
- CEA, DAM, DIF, 91297 Arpajon cedex, France
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
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110
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Tada A, Nagai T, Omote K, Tsujinaga S, Kamiya K, Konishi T, Sato T, Komoriyama H, Kobayashi Y, Takenaka S, Mizuguchi Y, Yamamoto K, Yoshikawa T, Saito Y, Anzai T. Validation of the HFA-PEFF and the H2FPEF scores for the diagnosis of heart failure with preserved ejection fraction in Japanese patients:a report from the Japanese multicentre registry. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The standard diagnosis of heart failure (HF) with preserved ejection fraction (HFpEF) is based on the following: 1) symptoms of HF, 2) preserved left ventricular (LV) ejection fraction (LVEF, >50%), and 3) presence of LV diastolic dysfunction confirmed by echocardiography or cardiac catheterisation. However, there are limits to the diagnostic accuracy of individual parameters, and what cut-off values should be applied and how they should be combined remain unclear. Diagnostic algorithms for HFpEF such as the HFA-PEFF algorithm and the H2FPEF score have been proposed; however, previous validation studies were conducted in stable chronic HF and did not include an invasive haemodynamic assessment. Thus, the diagnostic accuracy for HFpEF lacked robustness. Moreover, information on their applicability in the Asian population is limited.
Purpose
The aim of this study was to investigate these scores' diagnostic validity for HFpEF in Japanese patients recently hospitalised due to acute decompensated HF.
Methods
We examined patients with HFpEF recently hospitalised with acute decompensated HF whose HFA-PEFF and H2FPEF scores could be calculated at discharge from a nationwide HFpEF-specific multicentre registry (HFpEF group) and control patients who underwent echocardiography to investigate the cause of dyspnoea in our hospital (Non-HFpEF group). We calculated the HFA-PEFF and the H2FPEF scores among the studied population. Receiver operating characteristic (ROC) curves and area under the curve (AUC) were computed to compare the diagnostic accuracy of these scores.
Results
The studied population included 372 consecutive patients (194 HFpEF group and 178 Non-HFpEF group; HFpEF prevalence, 52%). The HFA-PEFF score classified 155 (42%) of all patients into the high likelihood category (5–6 points) and only 19 (5%) into the low likelihood category (0–1 point). A high HFA-PEFF score could diagnose HFpEF with a high specificity of 84% and a positive predictive value (PPV) of 82%, and a low HFA-PEFF score could rule out HFpEF with a high sensitivity of 99% and a negative predictive value (NPV) of 89%. The H2FPEF score classified 86 (23%) of all patients into the high likelihood category (6–9 points) and 84 (23%) into the low likelihood category (0–1 point). HFpEF could be diagnosed with a high H2FPEF score (specificity, 97%; PPV, 94%) or ruled out with a low H2FPEF score (sensitivity, 97%; NPV, 93%). The diagnostic accuracy for the HFA-PEFF and H2FPEF scores was 0.82 (95% confidence interval [CI] 0.78–0.86) and 0.89 (95% CI 0.86–0.93), respectively, by the AUC of the ROC curve (P=0.004) (Figure 1A). In the HFA-PEFF sub-scores, the functional score showed little diagnostic value, while the morphological and biomarker scores showed moderate diagnostic value (Figure 1B).
Conclusions
The H2FPEF score may be more useful than the HFA-PEFF score in diagnosing HFpEF in Japanese patients.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science (JSPS KAKENHI) Figure 1
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Affiliation(s)
- A Tada
- Hokkaido University, Sapporo, Japan
| | - T Nagai
- Hokkaido University, Sapporo, Japan
| | - K Omote
- Hokkaido University, Sapporo, Japan
| | | | - K Kamiya
- Hokkaido University, Sapporo, Japan
| | | | - T Sato
- Hokkaido University, Sapporo, Japan
| | | | | | | | | | | | | | - Y Saito
- Nara Medical University, Nara, Japan
| | - T Anzai
- Hokkaido University, Sapporo, Japan
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111
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Kanda M, Tateishi K, Nakagomi A, Iwahana T, Okada S, Kuwabara H, Kobayashi Y, Inoue T. Relationship of early intensive- or coronary care unit admission and post-discharge performance of activities of daily living in patients with acute decompensated heart failure. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The management of acute decompensated heart failure (ADHF) often requires intensive care. However, the effects of early intensive care unit (ICU)/coronary care unit (CCU) admission on activities of daily living (ADL) in ADHF patients have not been precisely evaluated. Thus, we assessed whether early ICU entry can improve post-discharge ADL performance in these patients.
Methods and results
ADHF patients (New York Heart Association I–III) admitted on emergency between April 1, 2014, and December 31, 2018, were selected from the Diagnosis Procedure Combination database and divided into ICU/CCU (ICU) and general ward (GW) groups according to the hospitalization type on admission day 1. The propensity score was calculated to create matched cohorts where treatment assignment (ICU/CCU admission) is independent of measured baseline confounding factors including ADL at admission. The primary outcome was post-ADL defined according to the Barthel index (BI) at discharge. Secondary outcomes included length of stay (LOS) and total hospitalization cost (expense). Overall, 12,231 patients were eligible, and propensity score matching created 2,985 pairs. After matching, post-ADL was significantly higher in the ICU group (GW 71.5±35.3 vs. ICU 78.2±31.2, P<0.001, difference in mean 6.7 (95% CI 5.1–8.4) points). After matching, LOS was significantly shorter and expenses were significantly higher in the ICU group. Subanalyses showed that patients with low ADL at admission (BI<60) mainly benefited from early ICU/CCU entry.
Conclusions
Early ICU/CCU entry was beneficially associated with post-ADL in patients with emergency ADHF admission. ADL at admission might serve as a useful criterion for ICU admission.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Kanda
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - K Tateishi
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - A Nakagomi
- Harvard T. H. Chan School of Public Health, Takemi Program in International Health, Boston, United States of America
| | - T Iwahana
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - S Okada
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - H Kuwabara
- Chiba University Hospital, Department of Healthcare Management Research Center, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiology, Chiba, Japan
| | - T Inoue
- Chiba University Hospital, Department of Healthcare Management Research Center, Chiba, Japan
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112
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Ono R, Miyauchi H, Iimori T, Sawada K, Kuwabara Y, Kobayashi Y. SPECT-guided myocardial perfusion and metabolic fatty acid planar imaging to assess the severity of the pulmonary hypertension in patients with chronic thromboembolic pulmonary hypertension. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Patients with chronic thromboembolic pulmonary hypertension (CTEPH) represent right ventricular (RV) enlargement and hypertrophy, which consequently increase the RV myocardial perfusion. Although the main energy source of myocardium is fatty acid, it remains unknown whether myocardial fatty acid metabolism is altered in loaded RV. Herein, we report a novel approach to assess the RV perfusion and fatty acid metabolism, which is called SPECT-guided planar imaging.
Purpose
To evaluate if SPECT-guided myocardial perfusion and metabolic fatty acid planar imaging reflects the severity of the pulmonary hypertension in patients with chronic thromboembolic pulmonary hypertension.
Methods
The study groups included 30 patients with CTEPH and 20 healthy controls. In these patients with CTEPH, 15 patients underwent pulmonary thromboendarterectomy (PEA). Mean pulmonary artery pressure (mPAP) by right heart catheterization was obtained in all CTEPH patients. 201Thallium (201Tl) and iodine-123-beta-methyl iodophenyl pentadecanoic acid (123I-BMIPP) planar myocardial imaging was performed in all participants. For the patients undergoing PEA, repetitive SPECT-guided 201Tl and 123I-BMIPP planar imaging was performed one year after the procedure. To assess the RV overload, the planar images were performed in left anterior oblique position, optimized to separate the RV from the left ventricular (LV) using SPECT-guided transverse imaging. We measured the total counts of 201Tl and 123I-BMIPP in both the RV and LV. Moreover, we calculated their relative counts of the RV to LV (abbreviated as HR/HL (Tl) and HR/HL (BMIPP), respectively) to determine the indices of myocardial perfusion and fatty acid metabolism, respectively.
Results
Both HR/HL (Tl) and HR/HL (BMIPP) were elevated in the CTEPH patients compared with control (0.62±0.14 vs. 0.36±0.07, p<0.01 and 0.57±0.14 vs. 0.34±0.06, p<0.01, respectively). In the CTEPH patients, average mPAP was 44.0±9.52 mmHg, which was correlated with HR/HL (Tl) (r=0.675, p<0.001) and HR/HL (BMIPP) (r=0.685, p<0.01). Furthermore, the decrease of average mPAP 1 year after PEA was positively associated with the decrease of HR/HL (Tl) (r=0.646, p<0.01) and HR/HL (BMIPP) (r=0.504, p<0.05) 1 year after PEA.
Conclusions
In patients with CTEPH, RV myocardial perfusion and fatty acid metabolism was upregulated and moderately correlated with mPAP. SPECT-guided 201Tl and 123I-BMIPP planar imaging is a novel and noninvasive imaging modality to assess the severity of PH.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Ono
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - H Miyauchi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Iimori
- Chiba University Hospital, Department of Radiology, Chiba, Japan
| | - K Sawada
- Chiba University Hospital, Department of Radiology, Chiba, Japan
| | - Y Kuwabara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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Nakano M, Kondo Y, Nakano M, Kajiyama T, Ito R, Takahira H, Kitagawa M, Sugawara M, Chiba T, Kobayashi Y. Prognosis of apical hypertrophic cardiomyopathy in patients with an implantable cardioverter defibrillator. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Prophylactic use of implantable cardioverter-defibrillators (ICDs) to prevent sudden cardiac death (SCD) is widely spread all over the world in patients with hypertrophic cardiomyopathy (HCM). Apical HCM is a phenotype variant of HCM, with hypertrophy predominantly affecting apex, that was initially described 30 years ago. Apical HCM patients may have different clinical prognosis compared with other subsets of HCM. In previous studies, apical HCM patients seem to have a more benign prognosis than other types of HCM. However, little is known about the long-term outcomes of apical HCM and there are many unclear points. Moreover, there are few reports about the clinical prognosis in apical HCM patients with an ICD.
Objective
The aim of this study is to identify the difference between the prognosis of apical and the other HCM patients with an ICD.
Methods
We retrospectively analyzed the database of our ICD clinic. All subjects had been implanted with an ICD from October 2006 to August 2017. We classified HCM patients into LV outflow tract obstruction (LVOTO) and midventricular obstruction (MVO), apical HCM and other non-obstructive types. We divided all the patients into apical and other types of HCM, and examined their background, incidence of appropriate ICD therapies, hospitalization for heart failure, electrical storm and death.
Results
A total of consecutive 62 Japanese HCM patients with an ICD (follow-up period, 86±25 months; age, 67±14 years; male sex, 85%; left ventricular ejection fraction, 57±12%; LV max wall-thickness, 19±5mm; LV apical aneurysm, 9.7%; HCM Risk-SCD, 4.4±3.0) were enrolled in this study. We classified them into 14 apical HCM and 48 other types of HCM patients. The clinical characteristics and major events of these patients are shown in the Figure. During the follow-up periods, there were no significant differences in the incidence of hospitalization for heart failure, electrical storm and death between the 2 groups (p=0.40; p=0.22; p=0.23). Appropriate therapies occurred in 5 of 14 (36%) patients with apical HCM and 4 of 48 (8.3%) patients with other types of HCM (p=0.022).
Conclusions
Appropriate ICD therapy was more prevalent in patients with apical HCM, compared to patients with other types of HCM. However, the incidences of hospitalization for heart failure, electrical storm and death were not significantly different between two groups.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kondo
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - H Takahira
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Kitagawa
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Sugawara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Chiba
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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114
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Funabashi N, Nakamura K, Sasaki T, Naito S, Kobayashi Y. Frequency and distribution of J waves in survivors of ventricular fibrillation relationship with presence of myocardial fibrotic and or fat change and coronary arterial stenosis on cardiac CT. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The presence and distribution of J waves, the occurrence of ventricular fibrillation (VF), and the presence of left ventricular (LV) myocardial fibrotic or fat change or coronary stenosis may be related.
Purpose
To determine the relationship of frequency and distribution of J waves with presence of myocardial fibrotic or fat change and coronary arterial stenosis on cardiac computed tomography (CT) in survivors of VF.
Methods
We conducted a retrospective analysis of 21 survivors of VF (17 males; mean age, 61±14 years) that were implanted with a cardioverter defibrillator and underwent cardiac CT.
Results
On ECG, four subjects had atrial fibrillation. The mean corrected QT interval was 442±39 msec. On CT, two subjects had significant coronary artery stenosis and 12 had LV myocardial fibrotic and/or fat change. The distribution of J waves were as follows: five subjects had J waves in II, III and aVF leads (three had myocardial fibrotic and/or fat change); and 2 had J waves in III lead (one had myocardial fibrotic and/or fat change). One subject each had J waves in V1 lead; V1, 2 leads; II, III, aVF and V1 leads; II, III, aVF and V1–3 leads; II, III, aVF, aVL and V1–6 leads; II, III, aVF and V1–6 leads; II, III, aVF and V4,5 leads; II, III, aVF and V2–5 leads; and III and aVF leads, respectively. The first two subjects did not have LV myocardial fibrotic and/or fat change and the remaining six subjects had myocardial fibrotic and/or fat change (Figure).
Conclusions
Survivors of VF with organized LV myocardial fibrotic and/or fat change showed more frequent J waves with a wider distribution (reached LV inferior wall leads) than survivors without these changes. Monitoring these characteristics on CT may be useful to predict VF.
Funding Acknowledgement
Type of funding sources: None. CT images of fat in a VF survivorJ waves and fibrotic and/or fat change
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Affiliation(s)
- N Funabashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - K Nakamura
- Gunma Prefectural Cardiovascular Center, Department of Cardiology, Maebashi, Japan
| | - T Sasaki
- Gunma Prefectural Cardiovascular Center, Department of Cardiology, Maebashi, Japan
| | - S Naito
- Gunma Prefectural Cardiovascular Center, Department of Cardiology, Maebashi, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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115
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Kondo Y, Miyazawa K, Nakano M, Kajiyama T, Nakano M, Kobayashi Y. Psychological assessment of depression and anxiety in patients with implantable cardioverter-defibrillator: DEFibrillator-related distress and depression survey in Chiba 2. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.2425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Despite the established treatment for life-threatening arrhythmias, the implantable cardioverter-defibrillator (ICD) therapy has emerged as a major determinant of psychological distress. Previous studies have showed several approaches to assess the ICD-specific psychological distress, however, the risk factors affecting psychological functioning are relatively variable across studies, and are not well studied in Japanese population. Therefore, we prospectively investigate the risk factors affecting the psychological functioning and assess the impact of ICD therapy in Japanese patients with ICD.
Methods
We prospectively enrolled consecutive 136 patients in the present study. At the time of ICD implantation and 1 year later, all patients completed the Florida Shock Anxiety Scale (FSAS), which is a tool designed to provide a quantitative measure of ICD shock-related anxiety. In addition, patients were also examined by psychiatrists using two assessment scales, Montgomery-Åsberg Depression Rating Scale (MADRS) and Hospital Anxiety and Depression Scale (HADS).
Results
The FSAS score was significantly correlated with the MADRS and HADS scores (Figure). During 1-year follow-up, 11 patients (8.1%) received ICD therapy. Younger age was significantly associated with the FSAS and MADRS scores at registration, but ICD therapy was the only independent factor associated with the increased risk of the FSAS score at 1 year later (p-value = 0.012).
Conclusions
ICD therapy has a strong impact on psychological distress in time course of ICD implantation. To reduce unnecessary shock therapy and optimal intervention by healthcare professionals may lead to the improvement of ICD-related psychological functioning.
Funding Acknowledgement
Type of funding sources: None. Figure 1. Correlation between MADRS and HADS scoreFigure 2. FSAS, MADRS and HADS scores
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Affiliation(s)
- Y Kondo
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - K Miyazawa
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therpeutics, Chiba, Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of Advanced Cardiorhythm Therpeutics, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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116
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Takenaka S, Kobayashi Y, Nagai T, Kato Y, Komoriyama H, Nagano N, Kamiya K, Konishi T, Sato T, Omote K, Tada A, Iwano H, Kusano K, Ishibashi-Ueda H, Anzai T. Applicability of the AHA/ACC/HRS guideline for implantable cardioverter defibrillator implantation in Japanese patients with cardiac sarcoidosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Sarcoidosis is a systemic granulomatous disease that affects multiple organs. Cardiac involvement is a key determinant of poor clinical outcomes in the patients with sarcoidosis, as it causes congestive heart failure, conduction abnormalities, ventricular tachycardia and fibrillation (VT/VF), and sudden cardiac death (SCD). Although implantable cardioverter defibrillators (ICDs) are used to prevent SCD from VT/VF in patients with cardiac sarcoidosis (CS), the generalizability of the AHA/ACC/HRS guidelines for the Japanese CS patients remains unclear.
Purpose
We aimed to assess, among Japanese patients with CS, the ICD recommendations from the 2017 AHA/ACC/HRS Guidelines for Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death.
Methods
We examined 188 consecutive patients with CS in two tertiary hospitals between 1979 and 2020. The primary outcome was defined as a composite outcome involving SCD or ventricular arrhythmic events. Ventricular arrhythmic events were defined as either emergency treatment for VF or sustained VT, which included appropriate ICD therapy.
Results
During a median follow-up period of 5.68 (IQR: 4.87–6.70) years, the primary outcome occurred in 44 patients (23%), which included 6 cases of SCD and 38 cases of VT/VF. ICD implant was indicated based on left ventricular ejection fraction (LVEF) of ≤35% (class I recommendation) in 62 patients, with an annualized event rate of 3.93%. A LVEF of >35% with a need for a permanent pacemaker (class IIa recommendation) was observed for 53 patients, with an annualized event rate of 2.54%. A LVEF of >35% with late gadolinium enhancement (LGE) during cardiovascular magnetic resonance (class IIa recommendation) was observed for 62 patients, with an annualized event rate of 2.38% (Figure A). Kaplan-Meier analyses revealed that patients with a class I recommendation for ICD implantation had a significant higher incidence of the primary outcome, compared to patients with a class IIa recommendation and patients with no indication for ICD implantation (P=0.03). However, there were no significant differences in the incidence of the primary outcome between patients with a LVEF of >35% and a need for a permanent pacemaker and patients with a class I recommendation (P=0.08) or patients with a LVEF of ≤35% (P=0.31). Moreover, there was no significant difference in the incidence of the primary outcome between patients with a LVEF of >35% and LGE on cardiovascular magnetic resonance and patients with a class I recommendation (P=0.054) or patients with a LVEF of ≤35% (P=0.22) (Figure B).
Conclusions
The American guideline recommendations for ICD implantation might be applicable to Japanese patients with CS. Implantation of an ICD may need to be considered in these patients if they require a permanent pacemaker or have LGE, regardless of LVEF.
Funding Acknowledgement
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Japan Society for the Promotion of Science
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Affiliation(s)
| | | | - T Nagai
- Hokkaido University, Sapporo, Japan
| | - Y Kato
- Hokkaido University, Sapporo, Japan
| | | | - N Nagano
- Sapporo Medical University Hospital, Sapporo, Japan
| | - K Kamiya
- Hokkaido University, Sapporo, Japan
| | | | - T Sato
- Hokkaido University, Sapporo, Japan
| | - K Omote
- Hokkaido University, Sapporo, Japan
| | - A Tada
- Hokkaido University, Sapporo, Japan
| | - H Iwano
- Hokkaido University, Sapporo, Japan
| | - K Kusano
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - H Ishibashi-Ueda
- National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - T Anzai
- Hokkaido University, Sapporo, Japan
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117
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Funabashi N, Kobayashi Y. Prediction of sites of wall thickening and abnormal late enhancement on cardiac CT and magnetic resonance imaging using electrocardiography findings in patients with confirmed cardiac amyloidosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Left ventricular (LV) wall thickening and diastolic dysfunction on a transthoracic echocardiogram (TTE) without high voltage R wave in V5 leads on ECG leads to a diagnosis of cardiac amyloidosis. A final diagnosis is made by endomyocardial biopsy. However, amyloid sometimes invade the right ventricle (RV), and left (LA) and right (RA) atria to cause ECG changes such as sick sinus syndrome (SSS), arrhythmia, and QRS wave axis deviation.
Purpose
To predict sites of wall thickening and abnormal late enhancement (LE) on cardiac computed tomography (CT) and magnetic resonance imaging (MRI), suggesting amyloid invasion, using cardiac rhythm and other ECG findings in patients with cardiac amyloidosis confirmed by biopsy.
Methods
A total of 26 patients (11 females) with suspected cardiac amyloidosis, showing LV wall thickening by TTE without a high voltage R wave in V5 leads on ECG, underwent cardiac enhanced CT. LV wall thickening on CT in the early phase led to late phase acquisition to detect LE. Five patients (3 females, mean age 73 years) were diagnosed with cardiac amyloidosis: complicated multiple myeloma, 2; senile ATTR (transthyretin) amyloidosis, 1; immunoglobulin light chain (AL) amyloidosis 1; and transthyretin mutation, 1. Four patients underwent cardiac MRI.
Results
Two patients (cases 1 and 2) had SSS (junctional rhythm), one had atrial tachycardia, and the remaining two (cases 4 and 5) had a normal sinus rhythm. In case 1, ECG showed a left axis QRS wave deviation, no low voltage R wave in limb leads and a mild LA load. Wall thickening in the basal interventricular septum (IVS), LV inferior-posterior wall, LA on CT, LE in the endocardium in whole LV, RV, and RA on CT, and LE in the endocardium in whole LV, RV, LA, and IVS on MRI were observed. In case 2, ECG showed a normal QRS wave axis, no low voltage R wave in limb leads, no LA load, wall thickening in whole LV, RV, LA, and IVS on CT, and unclear (CT) or no (MRI) LE. In case 3, ECG showed a normal QRS wave axis, with low voltage R wave in limb leads, no LA load, wall thickening in LA and basal IVS on CT, LE in LA and basal IVS on CT, and LE in LA only on MRI. In case 4, ECG showed left axis QRS wave deviation, a low voltage R wave in limb leads, and no LA load, wall thickening in the LA and RV moderator band on CT, unclear LE on CT, and LE in whole LV, endocardium in the RV, and whole IVS on MRI. In case 5, ECG showed a right axis QRS wave deviation, low voltage R wave in limb leads, and a mild LA load, wall thickening in the IVS, LV lateral wall, LV anterior wall, RA, RV outflow tract, and RA appendage, and no LE on CT (MRI not performed).
Conclusions
This pilot study of a few patients with cardiac amyloidosis revealed few links between cardiac rhythm and other ECG findings with sites of wall thickening and abnormal LE. However, a longer-term study of more patients may lead to detecting an association between these variables with this methodology.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- N Funabashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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118
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Kobayashi Y, Nagai T, Hirata K, Tsuneta S, Kato Y, Komoriyama H, Kamiya K, Konishi T, Sato T, Omote K, Ohira H, Kudoh K, Konno S, Anzai T. Association of high serum soluble interleukin 2 receptor levels with risk of adverse events in patients with cardiac sarcoidosis. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Sarcoidosis is a systemic granulomatous disease that affects multiple organs. Among these, the presence of cardiac involvement is recognised as a determinant of worse clinical outcomes. Soluble interleukin 2 receptor (sIL-2R) is a potentially useful biomarker in the diagnosis and evaluation of disease severity in patients with sarcoidosis. However, it remains to be seen whether sIL-2R is associated with the severity and activity of disease in patients with cardiac sarcoidosis (CS).
Purpose
The aims of this study were to investigate whether sIL-2R was associated with clinical outcomes and to clarify the relationship between sIL-2R levels and disease activity evaluated by 18F-fluorideoxyglucose in positron emission tomography/computed tomography (18F-FDG PET/CT) in patients with CS.
Methods
We examined 101 consecutive patients with CS who were admitted to our University HospitalbetweenMay 2003 and February 2020. Patients who had no data of serum sIL-2R levels before initiation of immunosuppressive therapy (n=18) were excluded. Ultimately, 83 patients were examined in this study. The primary outcome was a composite of advanced atrioventricular block (AVB), ventricular tachycardia or ventricular fibrillation (VT/VF), heart failure hospitalisation, and all-cause death. Inflammatory activity in the myocardium and lymph nodes were assessed by18F-FDG PET/CT. We used a published program to analyse the cardiac metabolic activity (CMA), and total lymph node glycolysis (TLyG), which are quantitative measures of FDG volume-intensity.
Results
During a median follow-up period of 2.96 (interquartile range 2.24–4.27) years, the primary outcome occurred in 24 patients (29%), including 1 advanced AVB, 13 VT/VF, 5 hospitalisations for heart failure, and 5 all-cause deaths. Kaplan-Meier analyses showed that the primary outcome occurred more frequently in patients with higher sIL-2R levels (>538 U/mL, the median) than in those with lower sIL-2R levels (Figure). A multivariable Cox regression analysis revealed that a higher sIL-2R level was independently associated with an increased subsequent risk of adverse events (hazard ratio 3.71, 95% confidence interval 1.63–8.44, p=0.002), even after adjustments for age, plasma B-type natriuretic peptide, estimated glomerular filtration rate, left ventricular ejection fraction, and late gadolinium enhancement, which are known to be strong determinants of worse clinical outcomes in patients with CS (Table). Furthermore, sIL-2R levels were significantly correlated with TLyG, the inflammatory activity in lymph nodes (r=0.346, p=0.003) but not with CMA, the inflammatory activity in myocardium (r=0.131, p=0.27).
Conclusions
Increased sIL-2R is associated with worse long-term clinical outcomes accompanied by increased systemic inflammatory activity in CS patients. These findings suggest the importance of assessing sIL-2R as a surrogate marker for further risk stratification in these patients.
Funding Acknowledgement
Type of funding sources: Public Institution(s). Main funding source(s): Japan Society for the Promotion of Science
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Affiliation(s)
- Y Kobayashi
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - T Nagai
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - K Hirata
- Hokkaido University, Department of Diagnostic Imaging, Sapporo, Japan
| | - S Tsuneta
- Hokkaido University, Department of Diagnostic Imaging, Sapporo, Japan
| | - Y Kato
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - H Komoriyama
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - K Kamiya
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - T Konishi
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - T Sato
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - K Omote
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
| | - H Ohira
- Hokkaido University, Department of Respiratory Medicine, Sapporo, Japan
| | - K Kudoh
- Hokkaido University, Department of Diagnostic Imaging, Sapporo, Japan
| | - S Konno
- Hokkaido University, Department of Respiratory Medicine, Sapporo, Japan
| | - T Anzai
- Hokkaido University, Department of Cardiovascular Medicine, Sapporo, Japan
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119
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Tateishi K, Kondo Y, Saito Y, Kitahara H, Kobayashi Y. Implantable cardioverter-defibrillator therapy after resuscitation from cardiac arrest in vasospastic angina. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients with vasospastic angina (VSA) who are resuscitated from sudden cardiac arrest (SCA) are at high risk of recurrent cardiovascular events. However, there are no recommendations for implantable cardioverter-defibrillator (ICD) therapy in the VSA and SCA patient guidelines.
Purpose
This study investigated the prognostic impact of ICD therapy on patients with VSA and SCA.
Methods
The present multi-center registry included 280 patients who were resuscitated from SCA and received ICD implantation as secondary prophylaxis. The patients were divided into two groups according to the presence of VSA. The primary endpoint was a composite of all-cause death and appropriate ICD therapy, including appropriate anti-tachycardia pacing and shock for recurrent ventricular arrhythmias.
Results
Of 280 patients, 51 (18%) had VSA. Among those without VSA, ischemic cardiomyopathy was the leading cause of SCA (38%), followed by non-ischemic cardiomyopathies and Brugada syndrome (Table 1). During the median follow-up period of 3.8 years, 23 (8%) patients died, and 72 (26%) underwent appropriate ICD therapy. The incidence of the primary endpoint was not significantly different between patients with and without VSA (24% vs 33%, p=0.19). Further, the incidence of the primary endpoint was not significantly different among the etiologies (Figure 1)
Conclusions
In a cohort of patients who underwent ICD implantation as secondary prophylaxis, long-term clinical outcomes were comparable between those with VSA and those with other cardiac diseases after SCA. The results suggest that ICD therapy may be considered in patients with VSA and those with other etiologies after resuscitation from SCA.
Funding Acknowledgement
Type of funding sources: None. Table 1. Patient characteristics and outcomesFigure 1. Incidence of the primary endpoint
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Affiliation(s)
- K Tateishi
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - Y Kondo
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - Y Saito
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - H Kitahara
- Chiba University Hospital, Cardiology, Chiba, Japan
| | - Y Kobayashi
- Chiba University Hospital, Cardiology, Chiba, Japan
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120
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Ono R, Kajiyama T, Ito R, Kobayashi Y. CO sign after mitral valve plasty and tricuspid annuloplasty. QJM 2021; 114:419-420. [PMID: 33580252 DOI: 10.1093/qjmed/hcab032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Ono
- From the Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - T Kajiyama
- From the Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - R Ito
- From the Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
| | - Y Kobayashi
- From the Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan
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121
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Hamada S, Yano K, Kobayashi Y, Kawabata T, Furuta T. Oxidaition of cyclic benzylic ethers by an electronically tuned nitroxyl radical. Tetrahedron Lett 2021. [DOI: 10.1016/j.tetlet.2021.153404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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122
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Kodithuwakku KAHT, Owada H, Miura H, Maruyama D, Hirano K, Suzuki Y, Kobayashi Y, Koike S. Effects of oral administration of timothy hay and psyllium on the growth performance and fecal microbiota of preweaning calves. J Dairy Sci 2021; 104:12472-12485. [PMID: 34538491 DOI: 10.3168/jds.2021-20259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/09/2021] [Indexed: 12/12/2022]
Abstract
The objective of this study was to evaluate the effects of oral administration of fiber from the first week of life on the growth and hindgut environment of preweaning calves. Twenty newborn female Holstein calves were divided into 2 groups as control and treatment. Calves in both groups were reared under the same feeding program except for oral fiber administration. Timothy hay and psyllium were mixed at a 50-to-6 ratio as a treatment diet for oral fiber administration. Calves in the treatment group were orally administered 50 g of fiber daily from 3 to 7 d of age and 100 g of fiber from 8 d of age until weaning. Feed intake and occurrence of diarrhea were recorded daily, and body weight (BW) was recorded weekly for the individual calf. Fresh feces were collected from calves at 7, 21, 35, 49, and 56 d of age to analyze fermentation parameters and microbiota to characterize the hindgut environment. Higher fiber intake in the treatment group due to oral administration of timothy and psyllium did not affect the starter intake and achieved higher BW at 21 d of age. The fecal pH, total volatile fatty acid, lactate, and ammonia nitrogen concentrations were not affected by oral fiber administration; meanwhile, the molar proportion of propionate was higher in the treatment group at 7 d of age. The difference in fecal microbiota in the calves subjected to the oral administration of fiber was observed within 21 d of life; Lactobacillus spp. and Prevotella spp. showed higher abundance, whereas that of Clostridium perfringens was decreased. These higher abundances of beneficial bacteria and lower abundance of pathogenic bacteria during early life may partly explain the higher BW of calves in the treatment group at 21 d of age. Furthermore, no adverse effect was observed for the BW and health status in the treatment group throughout the preweaning period. Therefore, early fiber feeding via oral administration potentially contributes to improving the hindgut environment in newborn calves, which leads to better growth of calves during the early stage of life.
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Affiliation(s)
| | - H Owada
- Central Research Institute for Feed and Livestock, ZEN-NOH, Kasama 319-0205, Japan
| | - H Miura
- Graduate School of Agriculture, Hokkaido University, Sapporo 060-8589, Japan
| | - D Maruyama
- Graduate School of Agriculture, Hokkaido University, Sapporo 060-8589, Japan
| | - K Hirano
- Central Research Institute for Feed and Livestock, ZEN-NOH, Kasama 319-0205, Japan
| | - Y Suzuki
- Graduate School of Agriculture, Hokkaido University, Sapporo 060-8589, Japan
| | - Y Kobayashi
- Graduate School of Agriculture, Hokkaido University, Sapporo 060-8589, Japan
| | - S Koike
- Graduate School of Agriculture, Hokkaido University, Sapporo 060-8589, Japan.
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123
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Kotoku R, Yanazume S, Kuroda T, Kobayashi Y, Kitazono I, Akahane T, Tanimoto A, Kobayashi H. Two Components of Variant Profiles in Primary Vaginal Carcinosarcoma via Next-Generation Sequencing and a Literature Review. Int J Surg Pathol 2021; 30:288-294. [PMID: 34463147 DOI: 10.1177/10668969211037915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Primary vaginal carcinosarcoma (VCS) is an extremely rare and aggressive tumor consisting of admixed malignant epithelial and mesenchymal elements. We report a case of VCS that was subjected to analysis by immunohistochemistry and next-generation sequencing (NGS). A 53-year-old woman with post-menopausal vaginal bleeding underwent surgical excision followed by concurrent chemoradiation. A well demarcated tumor was growing in a discontinuous fashion at a location some distance from both the cervix and vulva. Microscopically, the tumor consisted of adenocarcinoma components and sarcoma components consisting of a sheet-like growth of spindle-shaped cells, and we diagnosed this tumor as primary vaginal carcinosarcoma. NGS analysis of each component identified the following variants, TP53, PIK3CA, KRAS and FBXW7. A comparison of microsatellite instability (MSI) and tumor mutation burden (TMB) showed that within both tissues the sarcomatous components had a higher MSI and TMB than the carcinomatous components. This case supports "a monoclonal theory" with the genome profile being similar to other malignant mixed Müllerian tumors.
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Affiliation(s)
- Rakan Kotoku
- Department of Obstetrics & Gynecology, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
| | - Shintaro Yanazume
- Department of Obstetrics & Gynecology, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
| | - Takafumi Kuroda
- Course of Advanced Cancer Medicine for Gynecologic Cancer, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
| | - Yusuke Kobayashi
- Department of Obstetrics & Gynecology, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.,Department of Obstetrics and Gynecology, The Jikei University School of Medicine, Tokyo, Japan, Nishi-Shinbashi 3-25-8, Minato-ku, Tokyo 105-8461, Japan
| | - Ikumi Kitazono
- Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan.,Center for Human Genome and Gene Analysis, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Toshiaki Akahane
- Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan.,Center for Human Genome and Gene Analysis, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Akihide Tanimoto
- Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan.,Center for Human Genome and Gene Analysis, Kagoshima University Hospital, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan
| | - Hiroaki Kobayashi
- Department of Obstetrics & Gynecology, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.,Course of Advanced Cancer Medicine for Gynecologic Cancer, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan
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124
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Kobayashi Y, Kida Y, Kabuto Y, Morihara T, Sukenari T, Nakagawa H, Onishi O, Oda R, Kida N, Tanida T, Matsuda KI, Tanaka M, Takahashi K. Healing Effect of Subcutaneous Administration of Granulocyte Colony-Stimulating Factor on Acute Rotator Cuff Injury in a Rat Model. Tissue Eng Part A 2021; 27:1205-1212. [PMID: 34432525 DOI: 10.1089/ten.tea.2020.0239.a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Granulocyte colony-stimulating factor (G-CSF) is a cytokine that mobilizes bone marrow-derived cells (BMDCs) to peripheral blood and has been clinically used to treat neutropenia. Previously, we reported that BMDCs migrated into the rotator cuff repair site via peripheral blood in the healing process. However, techniques to accelerate the healing process using the peripheral blood pathway have not been established. We evaluated whether G-CSF has a noteworthy effect on improving rotator cuff healing by enhancing the influx of BMDCs into the peripheral blood. We used Sprague-Dawley rats and chimeric rats, selectively expressing green fluorescent protein (GFP) in BMDCs. Their bilateral supraspinatus tendons were resected and sutured to the greater tuberosity of the humerus using the Masson-Allen technique, and G-CSF was subcutaneously injected for 5 days after surgery. Several GFP-positive cells were observed around the enthesis in the G-CSF-treated group compared with that in the Control group. Histological analysis revealed that the tendon-to-bone maturing scores and the Safranin O-stained cartilaginous areas were significantly higher in G-CSF-injected rats than in the control rats at weeks 4 and 8 after surgery. Consistently, the ultimate force to failure in the G-CSF-treated group significantly increased compared with the Control group at weeks 4 and 8 after surgery. These results suggest that BMDCs mobilized into the peripheral blood after G-CSF administration migrated to the rotator cuff repair area and effectively enhanced rotator cuff healing by promoting tenocyte and cartilage matrix production. In conclusion, the BMDC mobilization technique by G-CSF treatment via peripheral blood will provide a potential therapeutic approach for rotator cuff healing with clinically relevant applications. Impact statement As the retear rate following rotator cuff repair is high, new methods to aid its healing are required. Granulocyte colony-stimulating factor (G-CSF) has been used clinically and may represent a novel approach to treating rotator cuff tear. Herein, using a rat model, we elucidate the kinetics of bone marrow-derived mesenchymal stem cells at the repair site following G-CSF administration and describe the underlying mechanism by which G-CSF can help promote the repair of the rotator cuff.
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Affiliation(s)
- Yusuke Kobayashi
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yoshikazu Kida
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yukichi Kabuto
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toru Morihara
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tsuyoshi Sukenari
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Haruhiko Nakagawa
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Okihiro Onishi
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ryo Oda
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Noriyuki Kida
- Faculty of Arts and Sciences, Kyoto Institute of Technology, Kyoto, Japan
| | - Takashi Tanida
- Department of Anatomy and Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ken Ichi Matsuda
- Department of Anatomy and Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masaki Tanaka
- Department of Anatomy and Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kenji Takahashi
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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125
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Ishimaru N, Fujikawa H, Kondo S, Kobayashi Y. Ectopic ovary presenting as mesenteric abscess. Ann R Coll Surg Engl 2021; 103:e285-e287. [PMID: 34414779 DOI: 10.1308/rcsann.2021.0032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Ectopic ovary is a rare gynaecological condition that results in problems with menstruation and pregnancy and may develop into a malignant tumour. However, as the condition is often asymptomatic, diagnosis is difficult and frequently delayed. We report a case of a 42-year-old female who presented with a 10-day history of abdominal pain. The patient underwent surgery that confirmed the diagnosis of an ectopic ovary with an internal abscess. The findings of our study indicate that ectopic ovaries can present with an abscess. Ectopic ovaries should be included in the differential diagnosis of masses with internal abscesses.
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Affiliation(s)
| | - H Fujikawa
- Suwa Central Hospital, Nagano, Japan.,The University of Tokyo, Tokyo, Japan
| | - S Kondo
- Suwa Central Hospital, Nagano, Japan
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126
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Kobayashi Y, Masakado S, Murai T, Hamada S, Furuta T, Takemoto Y. A bench-stable N-trifluoroacetyl nitrene equivalent for a simple synthesis of 2-trifluoromethyl oxazoles. Org Biomol Chem 2021; 19:6628-6632. [PMID: 34282812 DOI: 10.1039/d1ob00947h] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
ortho-Nitro-substituted N-trifluoroacetyl imino-λ3-iodane is a bench-stable trifluoroacetyl nitrene precursor, in which intra- and intermolecular halogen bonding (XB) plays an important role. Potential synthetic applications of this novel precursor were explored.
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Affiliation(s)
- Yusuke Kobayashi
- Department of Pharmaceutical Chemistry, Kyoto Pharmaceutical University, Yamashina-ku, Kyoto 607-8414, Japan.
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127
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Maeda E, Jwa SC, Kumazawa Y, Saito K, Iba A, Yanagisawa A, Kuwahara A, Saito H, Terada Y, Fukuda T, Ishihara O, Kobayashi Y. P–721 Probability of receiving assisted reproductive technology treatment through out-of-pocket payment and household income: A discrete choice experiment in Japan. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What is the probability that patients will receive assisted reproductive technology (ART) treatment based on their out-of-pocket payment and income class?
Summary answer
Higher-income patients opted for ART even at a higher cost, whereas an out-of-pocket payment was the most influential determinant in all income groups.
What is known already
Economic disparities affect access to ART treatment in many countries. At the time of this survey, Japan provided partial reimbursement for ART treatment exclusively for those in low- or middle-income classes due to limited governmental budgets. However, the optimal financial support by income class is unknown.
Study design, size, duration
We conducted a discrete choice experiment (DCE) in Japan in January 2020 including 824 women with fertility problems who were recruited via an online social research panel.
Participants/materials, setting, methods
Participants included women aged 25–44 years undergoing fertility diagnosis or treatment. They completed a DCE questionnaire including 16 hypothetical scenarios, created by orthogonal design, to measure six relevant ART attributes (pregnancy rate, risk of adverse effects, number of visits to outpatient clinics, consultation hours, kindness of staff, and out-of-pocket expense) and their relation to treatment choice. We used mixed-effect logistic regression models to estimate the probability of receiving ART treatment for each attribute.
Main results and the role of chance
Of the 1,247 eligible women recruited, 824 completed the survey (66% participation rate). All six attributes significantly influenced treatment preference, with participants valuing out-of-pocket payment the most, followed by pregnancy rates and kindness of staff. The odds ratios of each attribute to receiving ART treatment were 0.58 (95% confidence interval [CI]: 0.57 − 0.59) for out-of-pocket payments per additional 100,000 Japanese yen (JPY; i.e., 800 euros), 1.47 (95% CI: 1.43 − 1.53) for pregnancy rates per additional 5%, and 4.16 (95% CI: 3.73 − 4.64) for kindness of staff, after adjusting for clinical and socioeconomic factors. Significant interactions occurred between high household income (≥8 million JPY) and high out-of-pocket payment (≥500,000 JPY). However, the mean predicted probability of the highest-income patients (i.e., ≥10 million JPY) to receive ART treatment at the average cost without public funding (i.e., 400,000 JPY) was 47% (interquartile range: 18%−76%), whereas that of middle-income patients (i.e., 6–8 million JPY) to receive ART at the average subsidized cost (i.e., 100,000 JPY) was 60% (interquartile range: 33%–88%).
Limitations, reasons for caution
Other attributes not included in our DCE scenarios might be relevant in real-life settings. Choices made in a DCE would not wholly match the actual treatment choices.
Wider implications of the findings: The present DCE suggested that out-of-pocket payment was the primary determinant in patients’ ART decisions. High-income patients were more likely to receive ART treatment even at a high cost, but their ineligibility for government financial support due to their high income might discourage them from receiving treatment.
Trial registration number
NA
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Affiliation(s)
- E Maeda
- Akita University Graduate School of Medicine, Environmental Health Science and Public Health, Akita, Japan
| | - S C Jwa
- Saitama Medical University, Obstetrics and Gynecology, Saitama, Japan
| | - Y Kumazawa
- Akita University Graduate School of Medicine, Obstetrics and Gynecology, Akita, Japan
| | - K Saito
- Tokyo Medical and Dental University, Department of Comprehensive Reproductive Medicine, Tokyo, Japan
| | - A Iba
- Graduate School of Medicine- the University of Tokyo, Department of Public Health, Tokyo, Japan
| | - A Yanagisawa
- Graduate School of Medicine- the University of Tokyo, Department of Public Health, Tokyo, Japan
| | - A Kuwahara
- Graduate School of Biomedical Sciences- Tokushima University, Department of Obstetrics and Gynecology, Tokushima, Japan
| | - H Saito
- Umegaoka Women’s Clinic, ART center, Tokyo, Japan
| | - Y Terada
- Akita University Graduate School of Medicine, Obstetrics and Gynecology, Akita, Japan
| | - T Fukuda
- National Institute of Public Health, Center for Outcomes Research and Economic Evaluation for Health, Saitama, Japan
| | - O Ishihara
- Saitama Medical University, Obstetrics and Gynecology, Saitama, Japan
| | - Y Kobayashi
- Graduate School of Medicine- the University of Tokyo, Department of Public Health, Tokyo, Japan
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Takatsuji K, Kida Y, Furukawa R, Tachiiri H, Kobayashi Y, Morihara T, Takahashi K. Osteochondritis dissecans of the glenoid in adolescent baseball players: a report of 4 cases. JSES Rev Rep Tech 2021; 1:265-273. [PMID: 37588960 PMCID: PMC10426610 DOI: 10.1016/j.xrrt.2021.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Affiliation(s)
- Kenta Takatsuji
- Department of Orthopaedics, Fukuchiyama City Hospital, Kyoto, Japan
| | - Yoshikazu Kida
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | | | - Hisakazu Tachiiri
- Department of Orthopedic Surgery, Tachiiri Orthopedic Clinic, Kyoto, Japan
| | - Yusuke Kobayashi
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toru Morihara
- Rakuwakai Marutamachi Rehabilitation Clinic, Kyoto, Japan
| | - Kenji Takahashi
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Akahane T, Kitazono I, Kobayashi Y, Nishida-Kirita Y, Yamaguchi T, Yanazume S, Tabata K, Kobayashi H, Tanimoto A. Direct next-generation sequencing analysis using endometrial liquid-based cytology specimens for rapid cancer genomic profiling. Diagn Cytopathol 2021; 49:1078-1085. [PMID: 34319014 DOI: 10.1002/dc.24841] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/13/2021] [Accepted: 07/20/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Genomic examination of cytology specimens is often performed on cell blocks or conventional smears rather than on liquid-based cytology (LBC) specimens. Since LBC specimens preserve high-quality DNA, cancer genome profiling using next-generation sequencing (NGS) is also attainable from residual LBC specimens. One of the advantages of using LBC specimens for NGS is that it allows direct extraction of DNA from residual specimens, avoiding a sacrifice of smear slides and minimizing genomic profiling processing time. METHODS Endometrial LBC specimens were subjected to NGS analysis to validate the practicality of rapid cancer genomic profiling in a pathology laboratory. The extracted DNA was subjected to NGS using a customized cancer gene panel comprising 56 genes and 17 microsatellite regions. The workflow strategy was defined, and the processing time estimated for specimen sampling, cell counting, NGS run, and genome profiling. RESULTS NGS analysis of most LBC specimens revealed somatic mutations, tumor mutation burden, and microsatellite instability, which were almost identical to those obtained from formalin-fixed paraffin-embedded tissues. The processing time for direct NGS analysis and cancer genomic profiling of the residual LBC specimens was approximately 5 days. CONCLUSION The residual LBC specimens collected using endometrial cytology were verified to carry a high tumor fraction for NGS analysis and could serve as an alternate source for rapid molecular classification and diagnosis of endometrial cancers, as a routine process in a pathology laboratory.
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Affiliation(s)
- Toshiaki Akahane
- Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Center for Human Genome and Gene Analysis, Kagoshima University Hospital, Japan
| | - Ikumi Kitazono
- Unit of Surgical Pathology, Kagoshima University Hospital, Kagoshima, Japan
| | - Yusuke Kobayashi
- Advanced Cancer Medicine for Gynecologic Cancer, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | | | - Tomomi Yamaguchi
- Department of Pathology, Laboratory of Cancer Medical Science, Hokuto Hospital, Obihiro, Japan
| | - Shintaro Yanazume
- Department of Obstetrics and Gynecology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Kazuhiro Tabata
- Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroaki Kobayashi
- Advanced Cancer Medicine for Gynecologic Cancer, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Department of Obstetrics and Gynecology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Akihide Tanimoto
- Department of Pathology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Center for Human Genome and Gene Analysis, Kagoshima University Hospital, Japan.,Unit of Surgical Pathology, Kagoshima University Hospital, Kagoshima, Japan
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Kinoshita M, Tanabe Y, Yoshida K, Kurata A, Kobayashi Y, Uetani T, Inoue K, Nishimura K, Ikeda S, Mochizuki T, Kido T, Yamaguchi O. Left ventricular longitudinal strain is a major determinant of CT-derived three-dimensional maximum principal strain: comparison with two-dimensional speckle tracking echocardiography. Heart Vessels 2021; 37:31-39. [PMID: 34232385 DOI: 10.1007/s00380-021-01901-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/02/2021] [Indexed: 11/24/2022]
Abstract
Computed tomography (CT)-derived three-dimensional maximum principal strain (MP-strain) can provide incremental value to coronary CT angiography for cardiac dysfunction assessment with high diagnostic performance in patients with myocardial infarction. Global longitudinal strain (GLS) measured using two-dimensional speckle tracking echocardiography (2D-STE) is more sensitive than left ventricular ejection fraction (LVEF) for detecting early myocardial dysfunction. We aimed to compare CT-derived MP-strain with each of 2D-STE-derived strains (i.e., longitudinal, circumferential, and radial strains), and identify the major determinants of CT-derived MP-strain among 2D-STE-derived strains. We studied 51 patients who underwent cardiac CT and echocardiography. CT images were reconstructed at every 5% (0-95%) of the RR interval. A dedicated workstation was used to analyze CT-derived MP-strain on the 16-segment model. We calculated CT-derived global MP-strain with all the 16 segments on a per patient basis. Pearson's test was used to assess correlations between CT-derived MP-strain and STE-strain at global and segmental levels. The intra-class correlation coefficient for interobserver agreement for CT-derived global MP-strain was 0.98 (95% confidence interval 0.96-0.99). The low-CT-derived global MP-strain group (≤ 0.43) had more patients with LV dysfunction than the high-CT-derived global MP-strain group (> 0.43). CT-derived global MP-strain was associated with STE-GLS (r = 0.738, P < 0.001), global circumferential strain (r = 0.646, P < 0.001), and global radial strain (r = 0.432, P = 0.001). In multivariate analysis, STE-GLS had the strongest association to CT-derived global MP-strain among three directional STE-strains and LVEF by echocardiography (standardized coefficient = - 0.527, P < 0.001). STE-GLS is a major determinant of CT-derived global MP-strain. CT-derived MP-strain may enhance the value of coronary CT angiography by adding functional information to CT-derived LVEF.
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Affiliation(s)
- Masaki Kinoshita
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan.
| | - Yuki Tanabe
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Kazuki Yoshida
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Akira Kurata
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Yusuke Kobayashi
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Teruyoshi Uetani
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Katsuji Inoue
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Kazuhisa Nishimura
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Shuntaro Ikeda
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Teruhito Mochizuki
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
- Department of Radiology, I.M. Sechenov First Moscow State Medical University, 19c1, Bol'shaya Pirogovskaya Ulitsa, Moscow, 119146, Russia
| | - Teruhito Kido
- Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
| | - Osamu Yamaguchi
- Department of Cardiology, Pulmonology, Hypertension and Nephrology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, 791-0295, Japan
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Aoki R, Kobayashi Y, Nawata S, Kamide H, Yamamoto T, Furugori S, Sekikawa Z, Utsunomiya D. Computed tomography imaging of resuscitative endovascular balloon occlusion of the aorta (REBOA): pearls and pitfalls. Jpn J Radiol 2021; 39:1133-1140. [PMID: 34216346 PMCID: PMC8639547 DOI: 10.1007/s11604-021-01166-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022]
Abstract
Resuscitative endovascular balloon occlusion of the aorta (REBOA) is performed in patients with hemorrhagic shock who develop massive subdiaphragmatic bleeding. This procedure enables rapid and less invasive aortic blockade compared to resuscitative thoracotomy and aortic cross-clamp procedures. However, the REBOA procedure is often blindly performed in the emergency department without fluoroscopy, and the appropriateness of the procedure may be evaluated on computed tomography (CT) after REBOA. Therefore, radiologists should be familiar with the imaging features of REBOA. We present a pictorial review of the radiological findings of REBOA along with a description of the procedure, its complications, and pitfalls.
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Affiliation(s)
- Ryo Aoki
- Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama-shi, 4-57 Urafunecho, Minami-ku, Yokohama-shi, Kanagawa, 232-0024, Japan.
- Diagnostic Radiology, Yokohama City University Medical Center, Yokohama-shi, Kanagawa, Japan.
| | - Yusuke Kobayashi
- Diagnostic Radiology, Yokohama City University Medical Center, Yokohama-shi, Kanagawa, Japan
| | - Shintaro Nawata
- Diagnostic Radiology, Yokohama City University Medical Center, Yokohama-shi, Kanagawa, Japan
| | - Hiroyuki Kamide
- Diagnostic Radiology, Yokohama City University Medical Center, Yokohama-shi, Kanagawa, Japan
| | - Toh Yamamoto
- Diagnostic Radiology, Yokohama City University Medical Center, Yokohama-shi, Kanagawa, Japan
| | - Shintaro Furugori
- Advanced Critical Care and Emergency Center, Yokohama City University Graduate School of Medicine, Yokohama-shi, Kanagawa, Japan
| | - Zenjiro Sekikawa
- Diagnostic Radiology, Yokohama City University Medical Center, Yokohama-shi, Kanagawa, Japan
| | - Daisuke Utsunomiya
- Diagnostic Radiology, Yokohama City University Graduate School of Medicine, Yokohama-shi, 4-57 Urafunecho, Minami-ku, Yokohama-shi, Kanagawa, 232-0024, Japan
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Koike S, Ueno M, Miura H, Saegusa A, Inouchi K, Inabu Y, Sugino T, Guan LL, Oba M, Kobayashi Y. Rumen microbiota and its relation to fermentation in lactose-fed calves. J Dairy Sci 2021; 104:10744-10752. [PMID: 34218911 DOI: 10.3168/jds.2021-20225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/25/2021] [Indexed: 01/26/2023]
Abstract
In our previous studies, we revealed the effect of lactose inclusion in calf starters on the growth performance and gut development of calves. We conducted the present study as a follow-up study to identify the shift in rumen microbiota and its relation to rumen fermentation when calves are fed a lactose-containing starter. Thirty Holstein bull calves were divided into 2 calf starter treatment groups: texturized calf starter (i.e., control; n = 15) or calf starter in which starch was replaced with lactose at 10% (i.e., LAC10; n = 15) on a dry matter basis. All calves were fed their respective treatment calf starter ad libitum from d 7, and kleingrass hay from d 35. Rumen digesta were collected on d 80 (i.e., 3 wk after weaning) and used to analyze rumen microbiota and fermentation products. There was no apparent effect of lactose feeding on the α-diversity and overall composition of rumen microbiota. Amplicon sequencing and real-time PCR quantification of the 16S rRNA gene confirmed that the abundance of butyrate-producing bacteria (i.e., Butyrivibrio group and Megasphaera elsdenii) did not differ between the control and LAC10 groups. Conversely, the relative abundance of Mitsuokella spp., which produce lactate, succinate, and acetate, was significantly higher in the rumen of calves that were fed lactose, whereas the lactate concentration did not differ between the control and LAC10 groups. These findings suggest that the lactate production can be elevated by an increase of Mitsuokella spp. and then converted into butyrate, not propionate, since the proportion of propionate was lower in lactose-fed calves. In addition, we observed a higher abundance of Coriobacteriaceae and Pseudoramibacter-Eubacterium in the LAC10 group. Both these bacterial taxa include acetate-producing bacteria, and a positive correlation between the acetate-to-propionate ratio and the abundance of Pseudoramibacter-Eubacterium was observed. Therefore, the higher abundance of Coriobacteriaceae, Mitsuokella spp., and Pseudoramibacter-Eubacterium in the rumen of lactose-fed calves partially explains the increase in the proportion of rumen acetate that was observed in our previous study.
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Affiliation(s)
- S Koike
- Department of Animal Science, Hokkaido University, Sapporo, Japan 060-8589.
| | - M Ueno
- Department of Animal Science, Hokkaido University, Sapporo, Japan 060-8589
| | - H Miura
- Department of Animal Science, Hokkaido University, Sapporo, Japan 060-8589
| | - A Saegusa
- Dairy Technology Research Institute, Feed-Livestock and Guidance Department, The National Federation of Dairy Co-operative Associations, Nishi-shirakawa, Fukushima, Japan 969-0223
| | - K Inouchi
- Dairy Technology Research Institute, Feed-Livestock and Guidance Department, The National Federation of Dairy Co-operative Associations, Nishi-shirakawa, Fukushima, Japan 969-0223
| | - Y Inabu
- Graduate School of Integrated Sciences for Life, Hiroshima University, Higashi-Hiroshima, Japan 739-8528
| | - T Sugino
- Graduate School of Integrated Sciences for Life, Hiroshima University, Higashi-Hiroshima, Japan 739-8528
| | - L L Guan
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada T6G 2P5
| | - M Oba
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada T6G 2P5
| | - Y Kobayashi
- Department of Animal Science, Hokkaido University, Sapporo, Japan 060-8589
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Tsuchihashi Y, Arima Y, Takahashi T, Kanou K, Kobayashi Y, Sunagawa T, Suzuki M. Clinical Characteristics and Risk Factors for Severe Outcomes of Novel Coronavirus Infection, January-March 2020, Japan. J Epidemiol 2021; 31:487-494. [PMID: 34053961 PMCID: PMC8275442 DOI: 10.2188/jea.je20200519] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background Notifications of novel coronavirus infections increased in early 2020 in Japan. We described characteristics of novel coronavirus infection cases and analyzed risk factors for severe outcomes. Methods Cases were persons with laboratory-confirmed novel coronavirus infection reported under national surveillance between January and March 2020. Clinical characteristics were described, and risk factors of (1) intensive care unit [ICU] admission and (2) invasive ventilation/death were analyzed using Poisson regression. Results Among the 516 cases analyzed, median age was 60 years (range: 1–97 years) and 285 (55%) were male. Common symptoms/signs were fever (375/475, 79%), cough (353/465, 76%), and pneumonia (245/387, 63%). Ten (2%) cases died. Of the 348 cases with data, 50 (14%) required invasive ventilation. Adjusted for each other, male gender and 1-year increase in age were associated with ICU admission (risk ratio [RR] 4.18; 95% confidence interval [CI], 1.69–10.32 and RR 1.05; 95% CI, 1.03–1.08, respectively) and invasive ventilation/death (RR 2.79; 95% CI, 1.49–5.21 and RR 1.06; 95% CI, 1.04–1.08, respectively). Diabetes, dyslipidemia, hyperuricemia, and lung diseases were also associated with severe outcomes. Of the 80 cases asymptomatic at hospitalization, 40 developed symptoms and five of them >70 years of age required invasive ventilation. Conclusions The early stage of the novel coronavirus epidemic in Japan disproportionately affected the elderly. Older age, male gender, and underlying conditions were associated with severe outcomes. Notably, some elderly case-patients who were asymptomatic at diagnosis and promptly hospitalized still went on to develop severe disease, indicating the importance of careful monitoring of certain populations.
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Affiliation(s)
- Yuuki Tsuchihashi
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases (NIID)
| | - Yuzo Arima
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases (NIID)
| | - Takuri Takahashi
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases (NIID)
| | - Kazuhiko Kanou
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases (NIID)
| | - Yusuke Kobayashi
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases (NIID)
| | - Tomimasa Sunagawa
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases (NIID)
| | - Motoi Suzuki
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases (NIID)
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Kobayashi Y, Kato H, Yamagishi T, Shimada T, Matsui T, Yoshikawa T, Kurosu T, Shimojima M, Morikawa S, Hasegawa H, Saijo M, Oishi K. Severe Fever with Thrombocytopenia Syndrome, Japan, 2013-2017. Emerg Infect Dis 2021; 26:692-699. [PMID: 32186502 PMCID: PMC7101122 DOI: 10.3201/eid2604.191011] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We conducted an epidemiologic study of severe fever with thrombocytopenia syndrome (SFTS) in Japan during 2013–2017. Of 303 cases reported during that period, 133 (44%) were included in this study. The median time between onset of illness and diagnosis of SFTS shortened, from 11.5 to 3.0 days, but the case-fatality rate remained high, at 27%. In 64 patients (48%), a close contact with companion animals was reported within 2 weeks of disease onset. Of these 64 patients, 40 were surveyed further, and we confirmed that 3 had direct contact with body fluids of ill companion animals; 2 had direct contact with the saliva of an ill feral cat or pet dog. These patients reported no history of tick bite, suggesting that ill companion animals might be a source of SFTS virus transmission. Direct contact with the body fluids of ill companion animals should be avoided.
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Yoshinaga K, Araki M, Wada K, Sekito T, Watari S, Maruyama Y, Sadahira T, Nishimura S, Sako T, Edamura K, Kobayashi Y, Watanabe M, Watanabe T, Nasu Y. Well controlled patients with diabetes mellitus has the potential to expand the kidney donor pool. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00724-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Shibata K, Nakai S, Kobayashi Y, Ozawa K, Tamura K. MO781THE CATIONIC CELLULOSE BASED PAD REDUCE THE HEMOSTATIC TIME AFTER HEMODIALYSIS. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab103.0019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background and Aims
In case of prolonged bleeding at the vascular access site after hemodialysis, a nurse must compress the bleeding site longer than usual. This situation causes the risk of intravascular thrombosis and consumes valuable time of both patients and staff. Therefore, effective hemostatic agents are desired. Nowadays, chitosan is considered as one of the strongest hemostatic substance. Nipro Corporation and Artisan-lab co., Ltd found the cationic cellulose could clot blood faster than chitosan in the activated clotting time (Figure). After carefully examining its safety and efficacy, it was approved as medicine by the Japanese Ministry of Health, Labor and Welfare. Then, a trial to verify its clinical efficacy as a hemostat was conducted in the Toshin Clinic. In our clinic, the timer is set on the hemodialysis machine after the needles are removed and pressure is started after hemodialysis. We examined how long the timer should be set to be able to sufficiently stop bleeding in case cationic-cellulose pads are used.
Method
Of the 150 hemodialysis patients treated at the Toshin clinic; patients who agreed to this trial were enrolled. We set a timer for 5 minutes initially using cationic-cellulose pads for hemostasis, and was shortened in the next trial by 1 minute if the bleeding had been stopped. If the patient did not consent, the timer was not shortened further. from April 15th to December 31st in 2020. We checked the bleeding evidence of the puncture sites at the timing of immediately after relieving their compression. At their following hemodialysis session, we also checked the existence of adverse effects at their puncture sites, such as contact dermatitis or infection.
Results
Ten patients (9 men and 1 woman, Age 58.5y ±13.1) agreed to participate in this study. In the case of stable hemostasis, we continued to shorten the time by 1 minute each time, and added 1 minute in case of bleeding. After searching for the shortest time to achieve stable hemostasis, we confirmed hemostasis an average of 14.2 times in all cases. The average time to set for the timer was 3.0 ± 0.94 minutes (2-5 minutes). Two patients refused to shorten the time set for the timer, the hemostasis time were 5 and 4minutes respectively. The hemostasis time in all the other cases was equal or less than 3 minutes. In one case, the hemostasis time was reduced to 3 minutes with a cationic cellulose pad, compared to 30 minutes with The Neoplaster hemostatic pad (Nipro Corporation) which is made with the carboxymethyl cellulose. Of the 142 case compressions performed, 1 case resulted in bleeding and required 2 minutes of additional compressions. All cases did not have any adverse effects such as redness, itching or pain of their hemostatic pad attached sites.
Discussion
This study showed that the average time to set for the timer, when using cationic cellulose pad was 3 minutes on average, without any adverse effects. Cationic cellulose pads can stop bleeding safely, quickly and stably. At present, clinically available strong hemostatic agents are too expensive to be applied for many patients. But the cost to get the cationic-cellulose to make hemostatic pads may be reduced enough to be distributed to many hemodialysis patients because this material is mass-produced for hair conditioner, shampoo, and toothpaste.
Conclusion
The average time set for the timer was estimated around 3 minutes using the cationic cellulose pad. The cationic cellulose pad can save precious time and efforts of both patients and staff through its quick hemostasis.
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Chiba T, Kajiyama T, Sugawara M, Kitagawa M, Takahira H, Ito R, Nakano M, Nakano M, Kondo Y, Kobayashi Y. Right ventricular function as a predictor of appropriate therapy of implantable cardioverter defibrillator. Europace 2021. [DOI: 10.1093/europace/euab116.427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Aim
The purpose of this study was to evaluate the association of RV function and appropriate therapy of ICD.Methods: This study was a single-center retrospective cohort study. Consecutive patients who underwent ICD implantation for any diseases were enrolled except for non-dilated phase hypertrophic cardiomyopathy and channelopathy. Transthoracic echocardiographic parameters including left ventricular ejection fraction (LVEF), RV basal diameter, RV end-diastolic area, and right ventricular fractional area change (RVFAC) were evaluated. RV systolic dysfunction was defined as RVFAC <35%. Cox regression analysis was used to analyze the effects of those parameters on appropriate ICD therapy after the implantation.
Results
In total, 151 patients (60.9 ± 13.6 years, 117 males) consisting of 67 old myocardial infarction, 34 dilated cardiomyopathy, 19 cardiac sarcoidosis, and 31 others were enrolled. Eighty patients received an ICD as a secondary prophylaxis. Mean LVEF and RVFAC were 37.8 ± 13.9% and 33.2 ± 10.8%, respectively. RV systolic dysfunction was present in 86 (57.0%) patients, which was significantly associated with ICD therapy (odds ratio 2.313; 95% confidence interval 1.067-5.014; P = 0.034) according to a univariate analysis. There was no correlation between RVFAC and LVEF (correlation coefficient =0.064). Regarding the subjects LVEF > 35%, RV systolic dysfunction was an independent predictor of ICD therapy in a multivariate analysis.
Conclusion
RV systolic dysfunction was independently associated with increased ICD therapy despite of relatively preserved LVEF.
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Affiliation(s)
- T Chiba
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - T Kajiyama
- Chiba University Graduate School of Medicine, Department of of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - M Sugawara
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Kitagawa
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - H Takahira
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - R Ito
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - M Nakano
- Chiba University Graduate School of Medicine, Department of of Advanced Cardiorhythm Therapeutics, Chiba, Japan
| | - Y Kondo
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
| | - Y Kobayashi
- Chiba University Graduate School of Medicine, Department of Cardiovascular Medicine, Chiba, Japan
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138
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Ono R, Kato K, Saito Y, Kobayashi Y. Frank's sign with cyanotic cauliflower ear. QJM 2021; 114:209. [PMID: 33367821 DOI: 10.1093/qjmed/hcaa332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Ono
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - K Kato
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Y Saito
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Y Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
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139
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Anko M, Kobayashi Y, Banno K, Aoki D. Current Status and Prospects of Immunotherapy for Gynecologic Melanoma. J Pers Med 2021; 11:jpm11050403. [PMID: 34065883 PMCID: PMC8151394 DOI: 10.3390/jpm11050403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/05/2021] [Accepted: 05/07/2021] [Indexed: 12/24/2022] Open
Abstract
Gynecologic melanomas are rare and have a poor prognosis. Although immunotherapy (immune checkpoint inhibitors) and targeted therapy has greatly improved the systemic treatment of cutaneous melanoma (CM) in recent years, its efficacy in gynecologic melanomas remains uncertain because of the rarity of this malignancy and its scarce literature. This review aimed to evaluate the literature of gynecologic melanomas treated with immunotherapy and targeted therapy through a PubMed search. We identified one study focusing on the overall survival of gynecologic melanomas separately and five case series and nine case reports concentrating on gynecologic melanomas treated with an immune checkpoint inhibitor and/or targeted therapy. Furthermore, the KIT mutation has the highest rate among all mutations in mucosal melanoma types. The KIT inhibitors (Tyrosine kinase inhibitors: TKIs) imatinib and nilotinib could be the treatment options. Moreover, immune checkpoint inhibitors combined with KIT inhibitors may potentially treat cases of resistance to immune checkpoint inhibitors. However, because of the different conditions and a small number of cases, it is difficult to evaluate the efficacy of immunotherapy and targeted therapy for gynecologic melanoma rigorously at this time. Further prospective cohort or randomized trials of gynecologic melanoma alone are needed to assess the treatment with solid evidence.
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140
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Ono R, Iwahana T, Kobayashi Y. Ace-of-spades with tear drop sign in apical hypertrophic cardiomyopathy. QJM 2021; 114:130-131. [PMID: 33063122 DOI: 10.1093/qjmed/hcaa289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Ono
- Department of Cardiovascular Medicine, Chiba University Graduate school of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - T Iwahana
- Department of Cardiovascular Medicine, Chiba University Graduate school of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
| | - Y Kobayashi
- Department of Cardiovascular Medicine, Chiba University Graduate school of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan
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141
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Haginaka J, Kubo A, Kimachi T, Kobayashi Y. Retention and molecular-recognition mechanisms of molecularly imprinted polymers for warfarin derivatives and their application for the determination of warfarin in human serum. Talanta 2021; 232:122419. [PMID: 34074406 DOI: 10.1016/j.talanta.2021.122419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 12/22/2022]
Abstract
Monodisperse molecularly imprinted polymers (MIPs) for warfarin (WF), 4'-chlorowarfarin (CWF), 4'-bromowarfarin (BWF), 4'-nitrowarfarin (NWF) and 4'-methylwarfarin (MWF) (MIPWF, MIPCWF, MIPBWF, MIPNWF and MIPMWF, respectively) were prepared using 4-vinylpyridine (4-VPY) and ethylene glycol dimethacrylate as a functional monomer and crosslinker, respectively, by multi-step swelling and polymerization. The retention and molecular-recognition properties of those MIPs were evaluated in HILIC, and reversed- and normal-phase modes. According to 1H NMR studies, one-to-three complex formation of one WF or CWF molecule with three 4-VPY molecules occurred. Via computational approaches, the intermolecular interaction modes and energies between WF derivatives and 4-VPYs were evaluated by semi-empirical quantum chemistry methods and density functional theory calculations. Three major possible hydrogen bonding interaction modes were identified: the interactions between the 4-hydroxy group, α-proton (methylene C-H) and α-proton (methyl C-H) of the WF derivative and the nitrogen atoms of 4-VPYs. In HILIC and normal-phase modes, the interaction energies showed satisfactory correlations with the retention factors of the WF derivatives. In reversed-phase mode, the retention factors of the WF derivatives were described by the hydrophobicity and the acidity of the 4-hydroxy groups of the WF derivatives. These results demonstrate that three hydrogen bonding interactions in HILIC and normal-phase modes, and hydrogen bonding or ionic interactions and hydrophobic interactions in reversed-phase mode play important roles in the retention and molecular-recognition of the WF derivatives on MIPs. Furthermore, MIPBWF was successfully applied to the determination of WF in human serum by column-switching LC with high accuracy, precision and selectivity and without template-leakage problems.
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Affiliation(s)
- Jun Haginaka
- Institute for Biosciences, Mukogawa Women's University, 11-68, Koshien Kyuban-cho, Nishinomiya, 663-8179, Japan.
| | - Arisa Kubo
- School of Pharmacy and Pharmaceutical Sciences, Mukogawa Women's University, 11-68, Koshien Kyuban-cho, Nishinomiya, 663-8179, Japan
| | - Tetsutaro Kimachi
- School of Pharmacy and Pharmaceutical Sciences, Mukogawa Women's University, 11-68, Koshien Kyuban-cho, Nishinomiya, 663-8179, Japan
| | - Yusuke Kobayashi
- Department of Pharmaceutical Chemistry, Kyoto Pharmaceutical University, Yamashina-ku, Kyoto, 607-8414, Japan
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142
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Kitazono I, Akahane T, Sakihama M, Yanazume S, Matsushita M, Tabata K, Kobayashi Y, Kobayashi H, Umekita Y, Tanimoto A. Human Papilloma Virus 18-Positive Submucosal Small Cell Neuroendocrine Carcinoma of the Vagina: An Immunohistochemical and Genomic Study. Int J Surg Pathol 2021; 29:870-876. [PMID: 33792412 DOI: 10.1177/10668969211007569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Primary vaginal neuroendocrine carcinoma (NEC) is extremely rare among female genital tract tumors. Here, we report 2 cases of vaginal small cell NEC (SCNEC) using immunohistochemistry and next-generation sequencing (NGS) analysis. The 2 patients were in their mid-to-late 70s, presented with abnormal vaginal bleeding and had a vaginal submucosal mass. The biopsied or resected tumors showed a typical neuroendocrine morphology consisting of solid nests of atypical tumor cells, with no specific organoid patterns, and proliferating in the vaginal submucosa. Immunohistochemical analysis showed strong and diffuse expression of chromogranin A, synaptophysin, and p16, but no thyroid transcription factor 1 expression. Additionally, both cases were positive for human papillomavirus (HPV) 18. An NGS-based cancer panel analysis revealed that the tumors carried NF1 and AR mutations, but no major driver mutations were detected. The results of this study suggested that HPV18 infection is linked to vaginal SCNEC.
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Affiliation(s)
- Ikumi Kitazono
- 208512Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Toshiaki Akahane
- 208512Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Kagoshima University Hospital, Kagoshima, Japan
| | - Mika Sakihama
- 208512Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Shintaro Yanazume
- 208512Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | | | - Kazuhiro Tabata
- 208512Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yusuke Kobayashi
- 208512Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Hiroaki Kobayashi
- 208512Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | | | - Akihide Tanimoto
- 208512Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.,Kagoshima University Hospital, Kagoshima, Japan
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143
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Kim SH, Jung S, Seok B, Kim YS, Park H, Otsu T, Kobayashi Y, Kim C, Ishida Y. A compact and stable incidence-plane-rotating second harmonics detector. Rev Sci Instrum 2021; 92:043905. [PMID: 34243408 DOI: 10.1063/5.0047337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/05/2021] [Indexed: 06/13/2023]
Abstract
We describe a compact and stable setup for detecting the optical second harmonics, in which the incident plane rotates with respect to the sample. The setup is composed of rotating Fresnel rhomb optics and a femtosecond ytterbium-doped fiber laser source operating at the repetition frequency of 10 MHz. The setup including the laser source occupies an area of 1 m2 and is stable so that the intensity fluctuation of the laser harmonics can be less than 0.2% for 4 h. We present the isotropic harmonic signal of a gold mirror of 0.5 pW and demonstrate the integrity and sensitivity of the setup. We also show the polarization-dependent six-fold pattern of the harmonics of a few-layer WSe2, from which we infer the degree of local-field effects. Finally, we describe the extensibility of the setup to investigate the samples in various conditions such as cryogenic, strained, ultrafast non-equilibrium, and high magnetic fields.
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Affiliation(s)
- S H Kim
- Center for Correlated Electron Systems, Institute for Basic Science, Seoul 08826, Republic of Korea
| | - S Jung
- Center for Correlated Electron Systems, Institute for Basic Science, Seoul 08826, Republic of Korea
| | - B Seok
- Center for Correlated Electron Systems, Institute for Basic Science, Seoul 08826, Republic of Korea
| | - Y S Kim
- Center for Correlated Electron Systems, Institute for Basic Science, Seoul 08826, Republic of Korea
| | - H Park
- Department of Physics and Astronomy, Seoul National University, Seoul 08826, Republic of Korea
| | - T Otsu
- ISSP, The University of Tokyo, 5-1-5 Kashiwa-no-ha, Kashiwa, Chiba 277-8581, Japan
| | - Y Kobayashi
- ISSP, The University of Tokyo, 5-1-5 Kashiwa-no-ha, Kashiwa, Chiba 277-8581, Japan
| | - C Kim
- Center for Correlated Electron Systems, Institute for Basic Science, Seoul 08826, Republic of Korea
| | - Y Ishida
- Center for Correlated Electron Systems, Institute for Basic Science, Seoul 08826, Republic of Korea
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144
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Kawashima T, Nomura S, Tanoue Y, Yoneoka D, Eguchi A, Ng CFS, Matsuura K, Shi S, Makiyama K, Uryu S, Kawamura Y, Takayanagi S, Gilmour S, Miyata H, Sunagawa T, Takahashi T, Tsuchihashi Y, Kobayashi Y, Arima Y, Kanou K, Suzuki M, Hashizume M. Excess All-Cause Deaths during Coronavirus Disease Pandemic, Japan, January-May 2020 1. Emerg Infect Dis 2021; 27:789-795. [PMID: 33622468 PMCID: PMC7920666 DOI: 10.3201/eid2703.203925] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To provide insight into the mortality burden of coronavirus disease (COVID-19) in Japan, we estimated the excess all-cause deaths for each week during the pandemic, January–May 2020, by prefecture and age group. We applied quasi-Poisson regression models to vital statistics data. Excess deaths were expressed as the range of differences between the observed and expected number of all-cause deaths and the 95% upper bound of the 1-sided prediction interval. A total of 208–4,322 all-cause excess deaths at the national level indicated a 0.03%–0.72% excess in the observed number of deaths. Prefecture and age structure consistency between the reported COVID-19 deaths and our estimates was weak, suggesting the need to use cause-specific analyses to distinguish between direct and indirect consequences of COVID-19.
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145
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Hayama N, Kobayashi Y, Takemoto Y. Asymmetric hetero-Michael addition to α,β-unsaturated carboxylic acids using thiourea–boronic acid hybrid catalysts. Tetrahedron 2021. [DOI: 10.1016/j.tet.2021.132089] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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146
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Kobayashi Y, Hirasawa A, Chiyoda T, Ueki A, Masuda K, Misu K, Kawaida M, Hayashi S, Kataoka F, Banno K, Kosaki K, Aoki D. Retrospective evaluation of risk-reducing salpingo-oophorectomy for BRCA1/2 pathogenic variant carriers among a cohort study in a single institution. Jpn J Clin Oncol 2021; 51:213-217. [PMID: 33037428 DOI: 10.1093/jjco/hyaa173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/27/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Risk-reducing salpingo-oophorectomy is performed for the primary prevention of ovarian cancer in patients with hereditary breast-ovarian cancer syndrome. We performed risk-reducing salpingo-oophorectomy for the first time in Japan in 2008, and we experienced 20 cases of risk-reducing salpingo-oophorectomy through 2019. In the past, the use of risk-reducing salpingo-oophorectomy in Japan was restricted because it was not covered by a Japanese National Health Insurance. Since April 2020, risk-reducing salpingo-oophorectomy has been covered by insurance for patients with breast-ovarian cancer syndrome and pre-existing breast cancer, and this surgery is expected to become more widely implemented in Japan. METHODS To contribute to the widespread use of risk-reducing salpingo-oophorectomy in the future, we retrospectively reviewed 20 cases of risk-reducing salpingo-oophorectomy at our hospital cohort study to clarify the issues in its implementation. RESULTS The variant genes for which risk-reducing salpingo-oophorectomy was indicated were BRCA1 and BRCA2 in 13 (65%) and 7 patients (35%), respectively. The median age at which risk-reducing salpingo-oophorectomy was performed was 49 years (range, 38-58), 13 patients (65%) had gone through menopause, and 16 patients (80%) had a history of breast cancer. Of the five patients (25%) with vasomotor symptoms, four received Chinese medicine, and only one received hormone replacement therapy. Occult cancer was detected in the removed ovaries in two patients (10%), although no postoperative peritoneal carcinogenesis has been observed to date. CONCLUSIONS Women who paid for risk-reducing salpingo-oophorectomy out of pocket were older than the recommended age at which the procedure should be performed, and this may explain the higher rate of occult cancers than previously reported. We need to perform risk-reducing salpingo-oophorectomy at the recommended age to ensure that the procedure is effective for primary prevention.
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Affiliation(s)
- Yusuke Kobayashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo.,Center for Medical Genetics, Keio University School of Medicine, Tokyo
| | - Akira Hirasawa
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo.,Center for Medical Genetics, Keio University School of Medicine, Tokyo.,Department of Clinical Genomic Medicine, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama
| | - Tatsuyuki Chiyoda
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo
| | - Arisa Ueki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo
| | - Kenta Masuda
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo
| | - Kumiko Misu
- Center for Medical Genetics, Keio University School of Medicine, Tokyo
| | - Miho Kawaida
- Division of Diagnostic Pathology, Keio University Hospital, Tokyo
| | - Shigenori Hayashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo
| | - Fumio Kataoka
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo.,Department of Obstetrics and Gynecology, International University of Health and Welfare School of Medicine, Chiba, Japan
| | - Kouji Banno
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo
| | - Kenjiro Kosaki
- Center for Medical Genetics, Keio University School of Medicine, Tokyo
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo
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147
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Kobayashi Y, Banno K, Aoki D. Current status and future directions of ovarian cancer prognostic models. J Gynecol Oncol 2021; 32:e34. [PMID: 33559415 PMCID: PMC7930438 DOI: 10.3802/jgo.2021.32.e34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 01/13/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Yusuke Kobayashi
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
| | - Kouji Banno
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
| | - Daisuke Aoki
- Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan
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148
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Nakatsuji Y, Kobayashi Y, Masuda S, Takemoto Y. Azolium/Hydroquinone Organo-Radical Co-Catalysis: Aerobic C-C-Bond Cleavage in Ketones. Chemistry 2021; 27:2633-2637. [PMID: 33258523 DOI: 10.1002/chem.202004943] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 11/30/2020] [Indexed: 01/25/2023]
Abstract
Organo-radical catalysts have recently attracted great interest, and the development of this field can be expected to broaden the applications of organocatalysis. Herein, the first example of a radical-generating system is reported that does not require any photoirradiation, radical initiators, or preactivated substrates. The oxidative C-C-bond cleavage of 2-substituted cyclohexanones was achieved using an azolium salt and a hydroquinone as co-catalysts. A catalytic mechanism was proposed based on the results of diffusion-ordered spectroscopy and cyclic voltammetry measurements, as well as computational studies.
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Affiliation(s)
- Yuya Nakatsuji
- Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Shimoadachi-cho, Yoshida, Sakyo-ku, Kyoto 606-8501, Japan
| | - Yusuke Kobayashi
- Department of Pharmaceutical Chemistry, Kyoto Pharmaceutical University, 1 Misasagishichono-cho, Yamashina-ku, Kyoto, 607-8412, Japan
| | - Sakyo Masuda
- Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Shimoadachi-cho, Yoshida, Sakyo-ku, Kyoto 606-8501, Japan
| | - Yoshiji Takemoto
- Graduate School of Pharmaceutical Sciences, Kyoto University, 46-29 Shimoadachi-cho, Yoshida, Sakyo-ku, Kyoto 606-8501, Japan
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149
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Kuwajima A, Okumura H, Nakajo T, Hirose E, Irie R, Kobayashi Y, Higashizono K, Mizutani T. A Case Report Using Goose Neck Microsnare for Severe Cervical Internal Carotid Artery Occlusion with Dolichoarteriopathy. J Neuroendovasc Ther 2021; 15:688-694. [PMID: 37502367 PMCID: PMC10370562 DOI: 10.5797/jnet.tn.2020-0156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 12/28/2020] [Indexed: 07/29/2023]
Abstract
Objective We report the use of a Goose Neck microsnare for cervical internal carotid artery (ICA) occlusion in a patient with dolichoarteriopathy in whom it was difficult to achieve recanalization. Case Presentation A 65-year-old woman underwent thrombectomy for a tandem lesion of left M1 occlusion and left cervical ICA occlusion. Recanalization of left M1 occlusion was achieved. For left cervical ICA occlusion, we attempted multiple thrombectomy using an existing device, but a hard clot with mobility was caught due to dolichoarteriopathy, which made thrombectomy difficult. Using a Goose Neck microsnare, we were able to capture the thrombus and achieve recanalization. Conclusion Thrombectomy by capturing the thrombus using a Goose Neck microsnare may be useful for capturing hard clots with mobility when it is difficult to achieve recanalization with existing devices.
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Affiliation(s)
- Atsuuji Kuwajima
- Department of Neurosurgery, Showa University Hospital, Tokyo, Japan
| | - Hirotaka Okumura
- Department of Neurosurgery, Showa University Hospital, Tokyo, Japan
| | - Takato Nakajo
- Department of Neurosurgery, Showa University Hospital, Tokyo, Japan
| | - Eisuke Hirose
- Department of Neurosurgery, AOI Universal Hospital, Kawasaki, Kanagawa, Japan
| | - Ryo Irie
- Department of Neurosurgery, Showa University Hospital, Tokyo, Japan
| | - Yusuke Kobayashi
- Department of Neurosurgery, Showa University Hospital, Tokyo, Japan
| | - Kazuya Higashizono
- Department of Neurosurgery, Ebara Hospital, Tokyo Metropolitan Health and Hospitals Corporation, Tokyo, Japan
| | - Tohru Mizutani
- Department of Neurosurgery, Showa University Hospital, Tokyo, Japan
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150
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Sato Y, Tsuji Y, Kawauchi Y, Iizuka K, Kobayashi Y, Irie R, Sugiyama T, Mizutani T. Epileptogenic zone localization using intraoperative gamma oscillation regularity analysis in epilepsy surgery for cavernomas: patient series. Journal of Neurosurgery: Case Lessons 2021; 1:CASE20121. [PMID: 36033917 PMCID: PMC9394110 DOI: 10.3171/case20121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 11/23/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND In epilepsy surgery for cavernoma with intractable focal epilepsy, removal of
the cavernoma with its surrounding hemosiderin deposition and other extended
epileptogenic zone has been shown to improve postsurgical seizures. However,
there has been no significant association between such an epileptogenic zone
and intraoperative electrocorticography (ECoG) findings. The authors
recently demonstrated that high regular gamma oscillation (30–70 Hz)
regularity (GOR) significantly correlates with epileptogenicity. OBSERVATIONS The authors evaluated the utility of intraoperative GOR analysis in epilepsy
surgery for cavernomas. The authors also analyzed intraoperative ECoG data
from 6 patients with cavernomas. The GOR was calculated using a sample
entropy algorithm. In 4 patients, the GOR was significantly high in the area
with the pathological hemosiderin deposition. In 2 patients with temporal
cavernoma, the GOR was significantly high in both the hippocampus and the
area with the pathological hemosiderin deposition. ECoG showed no obvious
epileptic waveforms in 3 patients, whereas extensive spikes were observed in
3 patients. All patients underwent cavernoma removal plus resection of the
area with significantly high GOR. The 2 patients with temporal cavernomas
underwent additional hippocampal transection. All patients were seizure free
after surgery. LESSONS The high GOR may be a novel intraoperative marker of the epileptogenic zone
in epilepsy surgery for cavernomas.
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Affiliation(s)
- Yosuke Sato
- Department of Neurosurgery, Showa University School of Medicine, Tokyo, Japan; and
| | - Yoshihito Tsuji
- Department of Neurosurgery, Matsubara Tokushukai Hospital, Osaka, Japan
| | - Yuta Kawauchi
- Department of Neurosurgery, Showa University School of Medicine, Tokyo, Japan; and
| | - Kazuki Iizuka
- Department of Neurosurgery, Showa University School of Medicine, Tokyo, Japan; and
| | - Yusuke Kobayashi
- Department of Neurosurgery, Showa University School of Medicine, Tokyo, Japan; and
| | - Ryo Irie
- Department of Neurosurgery, Showa University School of Medicine, Tokyo, Japan; and
| | - Tatsuya Sugiyama
- Department of Neurosurgery, Showa University School of Medicine, Tokyo, Japan; and
| | - Tohru Mizutani
- Department of Neurosurgery, Showa University School of Medicine, Tokyo, Japan; and
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