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Yamamoto H, Kuroda H, Hiramoto N, Hasuike T, Doi A, Nishioka H. Successful maintenance treatment of disseminated nocardiosis with cerebral abscess in a severely immunocompromised patient allergic to trimethoprim-sulfamethoxazole using moxifloxacin and high-dose minocycline: A case report. J Infect Chemother 2024:S1341-321X(24)00121-1. [PMID: 38670455 DOI: 10.1016/j.jiac.2024.04.008] [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: 11/08/2023] [Revised: 03/08/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024]
Abstract
Nocardiosis in patients after allogeneic hematopoietic stem cell transplantation (HSCT) is rare, but is associated with a significant mortality risk. Although trimethoprim-sulfamethoxazole (TMP/SMX) remains the cornerstone of nocardiosis treatment, optimal alternative therapies for patients intolerant to TMP/SMX are not well-established. Herein, we report a case of disseminated nocardiosis with bacteremia and multiple lesions in the lungs and brain caused by Nocardia farcinica, in a 60-year-old man who had previously undergone allogeneic HSCT and was receiving immunosuppressants for severe chronic graft-versus-host disease. The patient received atovaquone for the prophylaxis of Pneumocystis pneumonia because of a previous serious allergic reaction to TMP/SMX. The patient was initially treated with imipenem/cilastatin and amikacin, which were later switched to ceftriaxone and amikacin based on the results of antimicrobial susceptibility testing. After switching to oral levofloxacin and a standard dose of minocycline, the patient experienced a single recurrence of brain abscesses. However, after switching to oral moxifloxacin and high-dose minocycline, the patient did not experience any relapses during the subsequent two years and seven months of treatment. In treating nocardiosis with brain abscesses, it is crucial to select oral antibiotics based on the antimicrobial susceptibility test results and pharmacokinetics, especially when TMP/SMX is contraindicated. A combination of oral moxifloxacin and high-dose minocycline could be a promising alternative therapy.
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Affiliation(s)
- Hiroshi Yamamoto
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
| | - Hirokazu Kuroda
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
| | - Nobuhiro Hiramoto
- Department of Hematology, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
| | - Toshikazu Hasuike
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
| | - Asako Doi
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
| | - Hiroaki Nishioka
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, 2-1-1 Minatojima-minamimachi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan.
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Sano M, Toyota T, Morimoto T, Noguchi Y, Shigeno R, Murai R, Okada T, Sasaki Y, Taniguchi T, Kim K, Kobori A, Ehara N, Kinoshita M, Doi A, Tomii K, Kihara Y, Furukawa Y. Risk stratification and prognosis prediction using cardiac biomarkers in COVID-19: a single-centre retrospective cohort study. BMJ Open 2024; 14:e082220. [PMID: 38658000 PMCID: PMC11043716 DOI: 10.1136/bmjopen-2023-082220] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 02/22/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVE There is a need for a robust tool to stratify the patient's risk with COVID-19. We assessed the prognostic values of cardiac biomarkers for COVID-19 patients. METHODS This is a single-centre retrospective cohort study. Consecutive laboratory-confirmed COVID-19 patients admitted to the Kobe City Medical Center General Hospital from July 2020 to September 2021 were included. We obtained cardiac biomarker values from electronic health records and institutional blood banks. We stratified patients with cardiac biomarkers as high-sensitive troponin I (hsTnI), N-terminal pro-B-type natriuretic peptide (NT-proBNP), creatine kinase (CK) and CK myocardial band (CK-MB), using the clinically relevant thresholds. Prespecified primary outcome measure was all-cause death. RESULTS A total of 917 patients were included. hsTnI, NT-proBNP, CK and CK-MB were associated with the significantly higher cumulative 30-day incidence of all-cause death (hsTnI: <5.0 ng/L group; 4.3%, 5.0 ng/L-99%ile upper reference limit (URL) group; 8.8% and ≥99% ile URL group; 25.2%, p<0.001. NT-proBNP: <125 pg/mL group; 5.3%, 125-900 pg/mL group; 10.5% and ≥900 pg/mL group; 31.9%, p<0.001. CK: CONCLUSIONS Elevation of cardiac biomarkers was associated with poor prognosis of COVID-19 patients.
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Affiliation(s)
- Madoka Sano
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Toshiaki Toyota
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takeshi Morimoto
- Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yu Noguchi
- Department of Cardiovascular Medicine, Tenri Hospital, Tenri, Japan
| | - Ryo Shigeno
- Department of Cardiovascular Medicine, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Ryosuke Murai
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Taiji Okada
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yasuhiro Sasaki
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tomohiko Taniguchi
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Kitae Kim
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Atsushi Kobori
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Natsuhiko Ehara
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Makoto Kinoshita
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Asako Doi
- Department of Infectious disease, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yasuki Kihara
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yutaka Furukawa
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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Nishikubo M, Shimomura Y, Yamamoto R, Maruoka H, Nasu S, Sakizono K, Nagai Y, Hiramoto N, Yonetani N, Kondo T, Miyakoshi C, Doi A, Ishikawa T. Sequential cellular and humoral responses after repetitive COVID-19 vaccination in patients treated with anti-CD20 antibodies. Br J Haematol 2024; 204:821-825. [PMID: 37964419 DOI: 10.1111/bjh.19207] [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: 10/24/2023] [Revised: 11/04/2023] [Accepted: 11/06/2023] [Indexed: 11/16/2023]
Abstract
Patients treated with anti-CD20 antibodies for haematological disorders have insufficient immune responses to mRNA COVID-19 vaccines; however, relevant sequential data are lacking. We sequentially evaluated the humoral and cellular immune responses in 22 patients who had received anti-CD20 antibodies within 12 months before the first vaccination, before and after the third and fourth vaccinations. Humoral responses improved gradually, along with the resolution of B-cell depletion. A steady increase was noted in cellular responses, regardless of the B-cell status. Our findings suggest the potential benefit of repeated vaccinations in these patients until B-cell recovery is confirmed while enhancing cellular responses.
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Affiliation(s)
- Masashi Nishikubo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Yoshimitsu Shimomura
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
- Department of Environmental Medicine and Population Science, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Ryusuke Yamamoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Hayato Maruoka
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Seiko Nasu
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Kenji Sakizono
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Yuya Nagai
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Nobuhiro Hiramoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Noboru Yonetani
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Tadakazu Kondo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Chisato Miyakoshi
- Department of Research Support, Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Asako Doi
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Takayuki Ishikawa
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
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Morita S, Uraki S, Ariyasu H, Tsuji T, Doi A, Furuta H, Yamoto T, Nakao N, Akamizu T, Matsuoka TA. Profiling of Unfolded Protein Response Markers and Effect of IRE1α-specific Inhibitor in Pituitary Neuroendocrine Tumor. Endocrinology 2024; 165:bqae008. [PMID: 38289718 DOI: 10.1210/endocr/bqae008] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 12/21/2023] [Accepted: 01/24/2024] [Indexed: 02/01/2024]
Abstract
CONTEXT Inositol-requiring enzyme 1α (IRE1α) and PKR-like ER kinase (PERK), which are endoplasmic reticulum (ER) membrane proteins, regulate the unfolded protein response (UPR). These molecules have recently gained attention as a novel therapeutic target in secretory tumors. The roles of the UPR in pituitary neuroendocrine tumors (PitNETs) are unclear. OBJECTIVE To clarify UPR profiling of PitNETs and to investigate the effect of pharmacological modulation of UPR by KIRA8, a newly developed IRE1α-specific inhibitor. METHODS In 131 patients with PitNETs, we evaluated RNA expression of UPR markers in PitNETs and their clinical phenotypes. Using GH3 cells, we examined the effects of KIRA8 and its combination with octreotide on UPR profiling, cell growth, and apoptosis. RESULTS Cytoprotective adaptive-UPR (A-UPR) markers were more increased in functioning PitNETs (FPitNETs, n = 112) than in nonfunctioning PitNETs (NFPitNETs, n = 19), while there was no difference in proapoptotic terminal-UPR (T-UPR) markers. Similarly, overt somatotroph tumors (STs, acromegaly, n = 11) increased A-UPR compared with silent STs (n = 10). In STs, serum IGF-1 levels were inversely correlated with Txnip mRNA expression, a representative T-UPR marker. KIRA8 inhibited cell growth and facilitated apoptosis in GH3 cells with increased expressions of T-UPR markers, which was enhanced by the combination with octreotide. Octreotide increased mRNA expression of Txnip and Chop, but decreased spliced Xbp1 under ER stress. Octreotide is suggested to inhibit activation of IRE1α but to reciprocally induce T-UPR under PERK. CONCLUSION UPR markers in FPitNETs are implicated as dominant A-UPR but blunted T-UPR. KIRA8, enhanced with octreotide, unbalances the UPR, leading to antitumor effects. Targeting IRE1α may provide a novel strategy to treat PitNETs.
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Affiliation(s)
- Shuhei Morita
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Shinsuke Uraki
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Hiroyuki Ariyasu
- Department of Diabetes and Endocrinology, Shizuoka General Hospital, Shizuoka 420-8527, Japan
| | - Tomoya Tsuji
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Asako Doi
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Hiroto Furuta
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Toshikazu Yamoto
- Department of Neurological Surgery, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Naoyuki Nakao
- Department of Neurological Surgery, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Takashi Akamizu
- Department of Internal Medicine, Kuma Hospital, Kobe 650-0011, Japan
| | - Taka-Aki Matsuoka
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
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Doi A, Iwata K, Yamamoto T, Ogura A, Nasu S, Kuroda H, Hasuike T. A descriptive study on the potential transmission of COVID-19 to hospitalized patients from a nursery school affiliated with it. J Infect Chemother 2024; 30:17-19. [PMID: 37689135 DOI: 10.1016/j.jiac.2023.09.004] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 07/16/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
INTRODUCTION During the epidemic of the Omicron variant of SARS-CoV-2, nosocomial transmissions from healthcare workers (HCWs) to patients occur frequently. The influence of COVID-19 on hospitalized patients from nursing schools affiliated with the hospitals is a concern but it had not been well studied. METHODS We here describe COVID-19 outbreaks at the nursery school affiliated with an acute-care hospital, during the surges of the Omicron variants on the transmission of SARS-CoV-2 children as well as for the patients who were judged to be the close contacts of patients of COVID-19 by contact investigation by PCR testing. RESULTS A total of 36 children and five caregivers were diagnosed with COVID-19 during the study period. Of the 206 preschoolers who had close contact with the infected persons, only 16 became positive (7.6%). Secondary transmission from the 36 preschool children to the parents as HCWs occurred in 19 (61%) out of 31 parents. Three hospitalized patients were judged to have unsafe contact with the infected HCWs but this did not result in their infections, making a total of zero transmission from the nursery school to the hospital. CONCLUSIONS Children at the nursery school are potential reservoirs for nosocomial transmissions at the affiliated hospital, but multiple practical measures might have prevented them to occur.
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Affiliation(s)
- Asako Doi
- Kobe City Medical Center Central Hospital, Department of Infectious Diseases, Japan; Kobe City Medical Center Central Hospital, Department of Infection Control, Japan.
| | - Kentaro Iwata
- Kobe University Hospital, Department of Infectious Diseases Therapeutics, Japan
| | - Tatsuya Yamamoto
- Kobe City Medical Center Central Hospital, Department of Infection Control, Japan
| | - Akiko Ogura
- Kobe City Medical Center Central Hospital, Department of Infection Control, Japan
| | - Seiko Nasu
- Kobe City Medical Center Central Hospital, Department of Infection Control, Japan; Kobe City Medical Center Central Hospital, Department of Laboratory Medicine, Japan
| | - Hirokazu Kuroda
- Kobe City Medical Center Central Hospital, Department of Infectious Diseases, Japan; Kobe City Medical Center Central Hospital, Department of Infection Control, Japan
| | - Toshikazu Hasuike
- Kobe City Medical Center Central Hospital, Department of Infectious Diseases, Japan; Kobe City Medical Center Central Hospital, Department of Infection Control, Japan
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Iwakura H, Takagi T, Inaba H, Doi A, Ueda Y, Uraki S, Takeshima K, Furukawa Y, Ishibashi T, Morita S, Matsuno S, Nishi M, Furuta H, Matsuoka TA, Akamizu T. Thyroid function, glycemic control, and diabetic nephropathy in patients with type 2 diabetes over 24 months: prospective observational study. BMC Endocr Disord 2023; 23:146. [PMID: 37430240 PMCID: PMC10332001 DOI: 10.1186/s12902-023-01393-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 06/28/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND The higher prevalence of thyroid dysfunction in type 1 diabetes patients has been well established, whereas it is a matter of debate whether that is also observed in type 2 diabetes patients. This study was conducted to reveal whether higher prevalence of thyroid dysfunction is observed in patients with type 2 diabetes. METHODS We examined thyroid functions and thyroid autoantibodies in 200 patients with type 2 diabetes and 225 controls, with 24 months follow up for those with type 2 diabetes. RESULTS Serum free triiodothyronine (fT3) levels and fT3/free thyroxine (fT4) ratio were significantly lower, while fT4 levels were significantly higher in patients with type 2 diabetes. The number of patients with thyroid dysfunction or patients positive for thyroid autoantibodies were not different between the two groups. The fT3/fT4 ratio was positively and negatively correlated with serum c-peptide and HbA1c levels, respectively, suggesting that the difference can be attributable to insulin resistance and diabetic control. In the follow-up observation, we found no significant correlation between basal thyrotropin (TSH), fT3, fT4 or fT3/fT4 ratio with the amounts of changes of HbA1c levels at 12 or 24 months after the basal measurements. There was a negative relationship between TSH levels and eGFR at baseline measurements, but TSH levels did not seem to predict future decline of eGFR levels. No relationship was observed between urine albumin/ g‧cre levels and thyroid function. CONCLUSION Thyroid dysfunction and thyroid autoantibodies were not different in prevalence between patients with type 2 diabetes and controls, although in patients with type 2 diabetes, the fT3/fT4 ratio was decreased. Basal thyroid function did not predict future diabetes control or renal function within 24 months of follow-up.
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Affiliation(s)
- Hiroshi Iwakura
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan.
| | - Tomoyuki Takagi
- Wakayama City Medical Association Seijinbyo Center, 2-1-2 Tebira, Wakayama, Wakayama, 640-8319, Japan
| | - Hidefumi Inaba
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Asako Doi
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Yoko Ueda
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Shinsuke Uraki
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Ken Takeshima
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Yasushi Furukawa
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Tatsuya Ishibashi
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Shuhei Morita
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Shohei Matsuno
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Masahiro Nishi
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Hiroto Furuta
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Taka-Aki Matsuoka
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
| | - Takashi Akamizu
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimiidera, Wakayama, 641-8509, Japan
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Yamada K, Kitai T, Iwata K, Nishihara H, Ito T, Yokoyama R, Inagaki Y, Shimogai T, Honda A, Takahashi T, Tachikawa R, Shirakawa C, Ito J, Seo R, Kuroda H, Doi A, Tomii K, Kohara N. Predictive factors and clinical impact of ICU-acquired weakness on functional disability in mechanically ventilated patients with COVID-19. Heart Lung 2023; 60:139-145. [PMID: 37018902 PMCID: PMC10036310 DOI: 10.1016/j.hrtlng.2023.03.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Patients with critical COVID-19 often require invasive mechanical ventilation (IMV) and admission to the intensive care unit (ICU), resulting in a higher incidence of ICU-acquired weakness (ICU-AW) and functional decline. OBJECTIVE This study aimed to examine the causes of ICU-AW and functional outcomes in critically ill patients with COVID-19 who required IMV. METHODS This prospective, single-center, observational study included COVID-19 patients who required IMV for ≥48 h in the ICU between July 2020 and July 2021. ICU-AW was defined as a Medical Research Council sum score <48 points. The primary outcome was functional independence during hospitalization, defined as an ICU mobility score ≥9 points. RESULTS A total of 157 patients (age: 68 [59-73] years, men: 72.6%) were divided into two groups (ICU-AW group; n = 80 versus non-ICU-AW; n = 77). Older age (adjusted odds ratio [95% confidence interval]: 1.05 [1.01-1.11], p = 0.036), administration of neuromuscular blocking agents (7.79 [2.87-23.3], p < 0.001), pulse steroid therapy (3.78 [1.49-10.1], p = 0.006), and sepsis (7.79 [2.87-24.0], p < 0.001) were significantly associated with ICU-AW development. In addition, patients with ICU-AW had significantly longer time to functional independence than those without ICU-AW (41 [30-54] vs 19 [17-23] days, p < 0.001). The development of ICU-AW was associated with delayed time to functional independence (adjusted hazard ratio: 6.08; 95% CI: 3.05-12.1; p < 0.001). CONCLUSIONS Approximately half of the patients with COVID-19 requiring IMV developed ICU-AW, which was associated with delayed functional independence during hospitalization.
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Affiliation(s)
- Kanji Yamada
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan; Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Takeshi Kitai
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
| | - Kentaro Iwata
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan; Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Hiromasa Nishihara
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Tsubasa Ito
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Rina Yokoyama
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Yuta Inagaki
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Takayuki Shimogai
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Akihiro Honda
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan
| | | | - Ryo Tachikawa
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Chigusa Shirakawa
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Jiro Ito
- Department of Anesthesia and Critical Care, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ryutaro Seo
- Department of Emergency Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hirokazu Kuroda
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Asako Doi
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Nobuo Kohara
- Department of Rehabilitation, Kobe City Medical Center General Hospital, Kobe, Japan
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Ebrahimi BS, Khwaounjoo P, Argus F, Chan HF, Nash MP, McGiffin D, Kaye D, Doi A, Joseph T, Whitford H, Tawhai MH. Predicting Patient Status in Chronic Thromboembolic Pulmonary Hypertension Using a Biophysical Model. Annu Int Conf IEEE Eng Med Biol Soc 2023; 2023:1-4. [PMID: 38083065 DOI: 10.1109/embc40787.2023.10340433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Chronic thromboembolic pulmonary hypertension (CTEPH) involves abnormally high blood pressure in the pulmonary vessels and is associated with small vessel vasculopathy and pre-capillary proximal occlusions. Management of CTEPH disease is challenging, therefore accurate diagnosis is crucial in ensuring effective treatment and improved patient outcomes. The treatment of choice for CTEPH is pulmonary endarterectomy, which is an invasive surgical intervention to remove thrombi. Following PEA, a number of patients experience poor outcomes or worse-than-expected improvements, which may indicate that they have significant small vessel disease. A method that can predict the extent of distal remodelling may provide useful clinical information to plan appropriate CTEPH patient treatment. Here, a novel biophysical modelling approach has been developed to estimate and quantify the extent of distal remodelling. This method includes a combination of mathematical modelling and computed tomography pulmonary angiography to first model the geometry of the pulmonary arteries and to identify the under-perfused regions in CTEPH. The geometric model is then used alongside haemodynamic measurements from right heart catheterisation to predict distal remodelling. In this study, the method is tested and validated using synthetically generated remodelling data. Then, a preliminary application of this technique to patient data is shown to demonstrate the potential of the approach for use in the clinical setting.Clinical relevance- Patient-specific modelling can help provide useful information regarding the extent of distal vasculopathy on a per-patient basis, which remains challenging. Physicians can be unsure of outcomes following pulmonary endarterectomy. Therefore, the predictive aspect of the patient's response to surgery can help with clinical decision-making.
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Kaye D, Fraser J, Jansz P, MacDonald P, Marasco S, Doi A, Merry C, Emmanuel S, Larbalestier R, Shah A, Geldenhuys A, Sibal A, Wasywich C, Kure C, McGiffin D. Favorable Impact of Hypothermic Machine Perfusion (HMP) on Early Renal Outcomes in Patients Undergoing Heart Transplantation Using Prolonged (6-8 Hour) Donor Hearts. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1702] [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: 04/05/2023] Open
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10
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Kaye D, Fraser J, Jansz P, MacDonald P, Marasco S, Doi A, Merry C, Emmanuel S, Leet A, Hare J, Cheshire C, Larbalestier R, Shah A, Wasywich C, Mathew J, Sibal A, Kure C, McGiffin D. Influence of Hypothermic Machine Perfusion (HMP) on Donor Heart Function Following an Ischemic Time of 6-8 Hours. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.138] [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: 04/05/2023] Open
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11
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Mitsuyuki S, Nishikubo M, Shimomura Y, Ohyama Y, Maruoka H, Nasu S, Kubo T, Suzuki Y, Okada N, Nakagawa D, Kamijo K, Yamamoto R, Nagai Y, Hiramoto N, Yoshioka S, Yonetani N, Hasegawa K, Kuroda H, Hasuike T, Doi A, Kondo T, Ishikawa T. Trajectories of the SARS-CoV-2 RNA load in patients with haematological malignancy. Eur J Haematol 2023. [PMID: 36965014 DOI: 10.1111/ejh.13967] [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: 01/11/2023] [Revised: 03/15/2023] [Accepted: 03/20/2023] [Indexed: 03/27/2023]
Abstract
OBJECTIVES The higher risk of prolonged viral shedding in coronavirus disease (COVID-19) patients with haematological malignancies (HM) necessitates test-based de-isolation strategies. However, evidence to establish their appropriate isolation period is insufficient. This study investigated the factors affecting prolonged viral shedding and the requisite isolation period in these patients. METHODS We retrospectively reviewed 14 COVID-19 patients with HM between January and April 2022, who were subjected to our test-based de-isolation strategy, followed by analysis of the viral load trajectory. The viral loads of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were evaluated using the cycle threshold (Ct) of the reverse-transcription quantitative polymerase chain reaction. The trajectories were classified according to the time-interval from COVID-19 onset to attainment of Ct values >30. RESULTS The median interval between onset and attainment of a Ct value >30 was 22 days. Five patients with mild or moderate COVID-19 without intense treatment histories achieved Ct values >30 within 20 days. The other nine patients needed more than 20 days, including three patients who did not meet this criterion during the observation period. CONCLUSIONS The SARS-CoV-2 viral load trajectories in patients with HM can be stratified by treatment history for the underlying HM and severity of COVID-19. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Satoshi Mitsuyuki
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Masashi Nishikubo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Yoshimitsu Shimomura
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
- Department of Environmental Medicine and Population Science, Graduate School of Medicine, Osaka University, Osaka, Japan
| | - Yukie Ohyama
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Hayato Maruoka
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Seiko Nasu
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Tomoyo Kubo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Yuta Suzuki
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Naoki Okada
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Daishi Nakagawa
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Kimimori Kamijo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Ryusuke Yamamoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Yuya Nagai
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Nobuhiro Hiramoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Satoshi Yoshioka
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Noboru Yonetani
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Kohei Hasegawa
- Department of Infectious diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Hirokazu Kuroda
- Department of Infectious diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Toshikazu Hasuike
- Department of Infectious diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Asako Doi
- Department of Infectious diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Tadakazu Kondo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Takayuki Ishikawa
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
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12
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Sano M, Toyota T, Morimoto T, Murai R, Okada T, Taniguchi T, Kim K, Kobori A, Ehara N, Kinoshita M, Doi A, Tomii K, Kihara Y, Furukawa Y. A COMBINED APPROACH USING HIGH-SENSITIVE TROPONIN I AND N-TERMINAL PRO-B-TYPE NATRIURETIC PEPTIDE FOR RISK STRATIFICATION IN PATIENTS WITH CORONAVIRUS DISEASE 2019. J Am Coll Cardiol 2023. [PMCID: PMC9982959 DOI: 10.1016/s0735-1097(23)01051-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
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13
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Nishikubo M, Shimomura Y, Maruoka H, Nasu S, Nishioka T, Sakizono K, Mitsuyuki S, Kubo T, Okada N, Nakagawa D, Kamijo K, Imoto H, Yamamoto R, Nagai Y, Hiramoto N, Yoshioka S, Yonetani N, Matsushita A, Miyakoshi C, Doi A, Ishikawa T. Humoral response and safety of the BNT162b2 and mRNA-1273 COVID-19 vaccines in allogeneic hematopoietic stem cell transplant recipients: An observational study. J Infect Chemother 2023; 29:274-280. [PMID: 36442827 PMCID: PMC9699714 DOI: 10.1016/j.jiac.2022.11.010] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The effectiveness of mRNA COVID-19 vaccines and the optimal timing of vaccine administration in allogeneic hematopoietic stem cell transplantation (Allo-HSCT) recipients remains inadequately investigated. We examine the effectiveness and safety of mRNA COVID-19 vaccines in allo-HSCT recipients. METHOD This prospective observational study included 44 allo-HSCT recipients and 38 healthy volunteers. The proportion of subjects acquiring anti-S1 IgG antibodies were considered as the primary endpoint. The occurrence of adverse events after vaccination and objective deterioration of chronic graft-versus-host disease (GVHD) were defined as secondary endpoints. In addition, we compared the geometric mean titers (GMT) of anti-S1 antibody titers in subgroups based on time interval between transplantation and vaccination. RESULTS A humoral response to the vaccine was evident in 40 (91%) patients and all 38 healthy controls. The GMT of anti-S1 titers in patients and healthy controls were 277 (95% confidence interval [CI]: 120-643) BAU/mL and 532 (95% CI 400-708) BAU/mL, respectively. (p = 0.603). A short time interval between transplantation and vaccination (≤6 months) was associated with low anti-S1 IgG antibody titers. No serious adverse events and deterioration of chronic GVHD were observed. Only one case of new development of mild chronic GVHD was recorded. CONCLUSION Messenger RNA COVID-19 vaccines induce humoral responses in allo-HSCT recipients and can be administered safely.
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Affiliation(s)
- Masashi Nishikubo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Yoshimitsu Shimomura
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan,Department of Environmental Medicine and Population Science, Graduate School of Medicine, Osaka University, Osaka, 565-0871, Japan,Corresponding author. Department of Hematology, Kobe City Medical Center General Hospital, 2-1-1 Minami-machi, Minatojima, Chuo-ku, Kobe, Hyogo, 650-0047, Japan
| | - Hayato Maruoka
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Seiko Nasu
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Tomomi Nishioka
- LSI Medience Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Kenji Sakizono
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Satoshi Mitsuyuki
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Tomoyo Kubo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Naoki Okada
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Daishi Nakagawa
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Kimimori Kamijo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Hiroharu Imoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Ryusuke Yamamoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Yuya Nagai
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Nobuhiro Hiramoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Satoshi Yoshioka
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Noboru Yonetani
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Akiko Matsushita
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Chisato Miyakoshi
- Department of Research Support, Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Asako Doi
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Takayuki Ishikawa
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
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14
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Hasegawa K, Doi A, Kuroda H, Hasuike T, Ogura A, Nasu S, Nishioka H, Tomii K. A pseudo-outbreak of COVID-19 associated pulmonary aspergillosis: a microbiological investigation of both the patients and the environment. J Infect Prev 2023; 24:83-88. [PMID: 36811012 PMCID: PMC9843133 DOI: 10.1177/17571774231152721] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 12/13/2022] [Indexed: 01/15/2023] Open
Abstract
Background We experienced a pseudo-outbreak of aspergillosis in a newly constructed COVID-19 ward. Within the first 3 months from the commencement of the ward, six intubated patients of COVID-19 developed probable or possible pulmonary aspergillosis. We suspected an outbreak of pulmonary aspergillosis associated with ward construction and launched air sampling for the investigation of the relationship between these. Methods The samples were collected at 13 locations in the prefabricated ward and three in the general wards, not under construction, as a control. Results The results from samples revealed different species of Aspergillus from those detected by the patients. Aspergillus sp. was detected not only from the air samples in the prefabricated ward but also in the general ward. Discussion In this investigation, we could not find evidence of the outbreak that links the construction of the prefabricated ward with the occurrence of pulmonary aspergillosis. It might suggest that this series of aspergillosis was more likely occurred from fungi that inherently colonized patients, and was associated with patient factors such as severe COVID-19 rather than environmental factors. Once an outbreak originating from building construction is suspected, it is important to conduct an environmental investigation including an air sampling.
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Affiliation(s)
- Kohei Hasegawa
- Infectious Diseases, Kobe City Medical Center General Hospital, Japan,Infection Control and Prevention, Kobe City Medical Center General Hospital, Japan
| | - Asako Doi
- Infectious Diseases, Kobe City Medical Center General Hospital, Japan,Infection Control and Prevention, Kobe City Medical Center General Hospital, Japan
| | - Hirokazu Kuroda
- Infectious Diseases, Kobe City Medical Center General Hospital, Japan,Infection Control and Prevention, Kobe City Medical Center General Hospital, Japan
| | - Toshikazu Hasuike
- Infectious Diseases, Kobe City Medical Center General Hospital, Japan,Infection Control and Prevention, Kobe City Medical Center General Hospital, Japan
| | - Akiko Ogura
- Infectious Diseases, Kobe City Medical Center General Hospital, Japan,Infection Control and Prevention, Kobe City Medical Center General Hospital, Japan,Nursing, Kobe City Medical Center General Hospital, Japan
| | - Seiko Nasu
- Infection Control and Prevention, Kobe City Medical Center General Hospital, Japan,Clinical Laboratory, Kobe City Medical Center General Hospital, Japan
| | - Hiroaki Nishioka
- Infectious Diseases, Kobe City Medical Center General Hospital, Japan,General Internal Medicine, Kobe City Medical Center General Hospital, Japan
| | - Keisuke Tomii
- Respiratory Medicine, Kobe City Medical Center General Hospital, Japan
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15
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Morita S, Takagi T, Inaba H, Furukawa Y, Kishimoto S, Uraki S, Shimo N, Takeshima K, Uraki S, Doi K, Imagawa M, Kokawa M, Konami T, Hara H, Hara Y, Sone E, Furuta H, Nishi M, Doi A, Tamura S, Matsuoka TA. Effect of SARS-CoV-2 BNT162b2 mRNA vaccine on thyroid autoimmunity: A twelve-month follow-up study. Front Endocrinol (Lausanne) 2023; 14:1058007. [PMID: 36777341 PMCID: PMC9911871 DOI: 10.3389/fendo.2023.1058007] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/12/2023] [Indexed: 01/28/2023] Open
Abstract
Objectives Graves' disease (GD) has been highlighted as a possible adverse effect of the respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccine. However, it is unknown if the SARS-CoV-2 vaccine disrupts thyroid autoimmunity. We aimed to present long-term follow-up of thyroid autoimmunity after the SARS-CoV-2 BNT162b2 mRNA vaccine. Methods Serum samples collected from seventy Japanese healthcare workers at baseline, 32 weeks after the second dose (pre-third dose), and 4 weeks after the third dose of the vaccine were analyzed. The time courses of anti-SARS-CoV-2 spike immunoglobulin G (IgG) antibody, thyroid-stimulating hormone receptor antibody (TRAb), and thyroid function were evaluated. Anti-thyroglobulin antibodies (TgAb) and anti-thyroid peroxidase antibodies (TPOAb) were additionally evaluated in thirty-three participants. Results The median age was 50 (IQR, 38-54) years and 69% were female. The median anti-spike IgG antibody titer was 17627 (IQR, 10898-24175) U/mL 4 weeks after the third dose. The mean TRAb was significantly increased from 0.81 (SD, 0.05) IU/L at baseline to 0.97 (SD, 0.30) IU/L 4 weeks after the third dose without functional changes. An increase in TRAb was positively associated with female sex (β = 0.32, P = 0.008) and low basal FT4 (β = -0.29, P = 0.02) and FT3 (β = -0.33, P = 0.004). TgAb was increased by the third dose. Increase in TgAb was associated with history of the thyroid diseases (β = 0.55, P <0.001). Conclusions SARS-CoV-2 BNT162b2 mRNA vaccine can disrupt thyroid autoimmunity. Clinicians should consider the possibility that the SARS-CoV-2 vaccine may disrupt thyroid autoimmunity.
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Affiliation(s)
- Shuhei Morita
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Tomoyuki Takagi
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Hidefumi Inaba
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
- Department of Diabetes and Endocrinology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Yasushi Furukawa
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Shohei Kishimoto
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Shinsuke Uraki
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Naoki Shimo
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Ken Takeshima
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Saya Uraki
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Kei Doi
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Mitsuyo Imagawa
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Mika Kokawa
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Tomomi Konami
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Hitomi Hara
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Yoshihiro Hara
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Emiko Sone
- Wakayama City Medical Association Seijinbyo Center, Wakayama, Japan
| | - Hiroto Furuta
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masahiro Nishi
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Asako Doi
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
| | - Shinobu Tamura
- Department of Emergency and Critical Care Medicine, Wakayama Medical University, Wakayama, Japan
| | - Taka-aki Matsuoka
- First Department of Medicine, Wakayama Medical University, Wakayama, Japan
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16
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Nishikubo M, Shimomura Y, Yamamoto R, Yoshioka S, Maruoka H, Nasu S, Nishioka T, Sakizono K, Mitsuyuki S, Kubo T, Okada N, Nakagawa D, Kamijo K, Imoto H, Nagai Y, Hiramoto N, Yonetani N, Kondo T, Miyakoshi C, Doi A, Ishikawa T. Humoral and cellular responses after COVID-19 booster vaccination in patients recently treated with anti-CD20 antibodies. Blood Cancer J 2023; 13:17. [PMID: 36690628 PMCID: PMC9868506 DOI: 10.1038/s41408-023-00792-z] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 01/14/2023] [Accepted: 01/16/2023] [Indexed: 01/24/2023] Open
Affiliation(s)
- Masashi Nishikubo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Yoshimitsu Shimomura
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan.
- Department of Environmental Medicine and Population Science, Graduate School of Medicine, Osaka University, Osaka, 565-0871, Japan.
| | - Ryusuke Yamamoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Satoshi Yoshioka
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Hayato Maruoka
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Seiko Nasu
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Tomomi Nishioka
- LSI Medience Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Kenji Sakizono
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Satoshi Mitsuyuki
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Tomoyo Kubo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Naoki Okada
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Daishi Nakagawa
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Kimimori Kamijo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Hiroharu Imoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Yuya Nagai
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Nobuhiro Hiramoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Noboru Yonetani
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Tadakazu Kondo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Chisato Miyakoshi
- Department of Research Support, Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Asako Doi
- Department of Infectious diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Takayuki Ishikawa
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
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17
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Sano M, Toyota T, Morimoto T, Okada T, Sasaki Y, Taniguchi T, Kim K, Kobori A, Ehara N, Kinoshita M, Doi A, Tomii K, Kihara Y, Furukawa Y. Prediction of clinical outcomes in patients with coronavirus disease 2019 using high-sensitive troponin I and N-terminal pro-B-type natriuretic peptide. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2309] [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
Several comorbidities, including cardiovascular diseases or myocardial injury, are reported to be associated with poor prognosis in patients with Coronavirus disease 2019 (COVID-19). However, detailed prognostic analysis of myocardial injury by various biomarkers in COVID-19 patients is limited.
Purpose
This study aims to explore the prognostic values of high-sensitive Troponin I (hsTnI) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) for COVID-19 patients using Japanese real-world data.
Methods
The COVID-MI study is a retrospective cohort study that enrolls consecutive laboratory-confirmed COVID-19 patients admitted to the hospital from July 2020 to September 2021. We collected clinical data, including cardiac biomarker values, by chart review. If the prespecified biomarkers in concern were not available, we measured them using the institutional serum blood bank, which enrolled patients prospectively from July 2020. Patients with available biomarkers were analyzed according to the values of hsTnI or NT-proBNP, using the clinically relevant thresholds (hsTnI: 5 ng/L and 99th percentile of the upper reference limit [99%ile URL], and NT-proBNP: 125 pg/mL and 900 pg/mL). The primary outcome measure was all-cause death. Secondary outcome measures included acute respiratory distress syndrome, myocardial infarction, myocarditis/pericarditis, venous thromboembolism, cerebral infarction, and bleeding events.
Results
We enrolled 917 patients with COVID-19 confirmed by viral nucleic acid amplification test. The mean age was 61 years, and 591 patients (64%) were men. On admission, the number of patients classified as severe or critical COVID-19 was 515 (56%) and 85 (8.7%), respectively. Among the 544 patients with hsTnI values, 365 (67%) patients had elevated hsTnI of ≥5 ng/L, and 134 patients (25%) had TnI of ≥99%ile URL. Besides, among 546 patients with NT-proBNP values, 295 patients (54%) had elevated NT-pro-BNP of ≥125 pg/mL, and 93 patients (17%) had NT-proBNP of ≥900 pg/mL. The median follow-up period was 31 days (interquartile range: 11–90 days). In cumulative incidence analysis, higher levels of hsTnI and NT-proBNP were associated with significantly higher mortality (hsTnI: <5 ng/L group; 8.8%, 5 ng/L to 99%ile URL group; 19%, and ≥99%ile URL group; 37%, P<0.001, and NT-proBNP: <125 pg/mL group; 7.8%, 125 to 900 pg/mL group; 21%, and ≥900 pg/mL group; 45%, P<0.001). The adjusted risk for all-cause death remained significant for each threshold of cardiac biomarkers (hsTnI ≥99%ile URL: hazard ratio [HR] 1.98, 95% confidence interval [CI] 1.11–3.54, P=0.02, and NT-proBNP ≥900 pg/mL: HR 3.60, 95% CI 1.86–6.98, P<0.001).
Conclusion
Elevation of hsTnI or NT-proBNP was associated with poor prognosis in the current relatively severely ill COVID-19 patients. Measuring hsTnI or NT-proBNP can be an attractive option for risk stratification and deciding appropriate management in patients with COVID-19.
Funding Acknowledgement
Type of funding sources: Public hospital(s). Main funding source(s): Institutional Research Fund at Kobe City Medical Center General Hospital
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Affiliation(s)
- M Sano
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine , Kobe , Japan
| | - T Toyota
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine , Kobe , Japan
| | - T Morimoto
- Kobe City Medical Center General Hospital, Center for Clinical Research and Innovation , Kobe , Japan
| | - T Okada
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine , Kobe , Japan
| | - Y Sasaki
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine , Kobe , Japan
| | - T Taniguchi
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine , Kobe , Japan
| | - K Kim
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine , Kobe , Japan
| | - A Kobori
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine , Kobe , Japan
| | - N Ehara
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine , Kobe , Japan
| | - M Kinoshita
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine , Kobe , Japan
| | - A Doi
- Kobe City Medical Center General Hospital, Department of Infectious Diseases , Kobe , Japan
| | - K Tomii
- Kobe City Medical Center General Hospital, Department of Respiratory Medicine , Kobe , Japan
| | - Y Kihara
- Kobe City Medical Center General Hospital , Kobe , Japan
| | - Y Furukawa
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine , Kobe , Japan
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18
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Moriyama Y, Doi A, Shinkai N, Nasu S, Mesaki K, Horii K, Ohmagari N, Hayakawa K. Clinical characteristics and risk factors for multidrug-resistant bacterial isolation in patients with international travel history. Am J Infect Control 2022; 51:660-667. [PMID: 36031036 DOI: 10.1016/j.ajic.2022.08.020] [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: 04/20/2022] [Revised: 08/18/2022] [Accepted: 08/18/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND International travelers are at risk of carrying resistant bacteria. It is critical to identify risk factors associated with multidrug-resistant organism (MDRO) colonization in travelers. METHODS A retrospective chart review observational study was conducted at two tertiary centers in Japan for inpatients who had been hospitalized or visited an outpatient clinic overseas within the previous 12 months. These patients underwent MDRO screening upon admission. To identify independent predictors for the isolation of MDROs, multivariable analyses were performed using logistic regression. RESULTS In total, 76 (35%) of the 216 patients were positive for MDROs at admission. The majority of bacteria detected in stool samples were extended-spectrum beta-lactamase-producing Escherichia coli (ESBLEC) (n = 67 [89%]). ESBLEC was detected in nearly 40% of patients who traveled to Asia. Travel to Asia was an independent risk factor for any MDRO and ESBLEC isolation. For non-ESBLEC MDRO isolation, a history of surgery abroad was an independent risk factor for detection. DISCUSSION AND CONCLUSIONS A history of hospitalization abroad has previously been found to be associated with MDRO colonization in travelers, which was not identified as a risk factor in this study. The risk factors for MDRO colonization were different between ESBLEC and non-ESBL MDROs.
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Affiliation(s)
- Yuki Moriyama
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Asako Doi
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Noriko Shinkai
- Department of Infection Control, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Seiko Nasu
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Kazuhisa Mesaki
- Department of Clinical Laboratory, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kumi Horii
- Infection Control and Prevention, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan.
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19
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Imoto H, Yoshioka S, Nakagawa D, Hasegawa K, Kuroda H, Hasuike T, Doi A, Kusumoto T, Ishikawa T. Cold agglutinin anti-I antibodies in two patients with COVID-19. J Clin Lab Anal 2022; 36:e24629. [PMID: 35917437 PMCID: PMC9459301 DOI: 10.1002/jcla.24629] [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] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/07/2022] Open
Abstract
Background Cold agglutinin syndrome (CAS) is associated with various diseases. Several studies of CAS associated with coronavirus disease 2019 (COVID‐19) reported hemolytic anemia and thrombosis; however, the clinical significance of cold agglutinins (CA) in patients with COVID‐19 is unclear. Here, we present two cases of CA identified in the context of COVID‐19 without hemolytic anemia and clotting. Case report and Discussion Two patients with no known risk factors for CA were diagnosed with COVID‐19; peripheral blood smears reveal red blood cells (RBCs) agglutination. These patients showed a high CA titer. We confirmed retrospectively that the CA was an anti‐I antibody. The two COVID‐19 cases with a high CA titer showed no hemolysis or thrombosis. Mycoplasma pneumoniae is known to cause CAS, but not all patients who have a high CA titer show hemolysis. Coagulation abnormalities are documented in severe COVID‐19 cases. Although CA increases the risk of thrombosis in those with lymphoproliferative diseases, the role of anti‐I antibodies in COVID‐19 is unclear. The impact of CAS on clinical presentations in COVID‐19 remains a matter of verification. Conclusions A high CA titer was identified in COVID‐19 patients without hemolytic anemia and clotting. Anti‐I antibodies were identified. Further studies are required to clarify the pathophysiology of CA in COVID‐19.
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Affiliation(s)
- Hiroharu Imoto
- Department of HematologyKobe City Medical Center General HospitalKobeJapan
- Department of Hematology and Clinical ImmunologyNishi Kobe Medical CenterKobeJapan
| | - Satoshi Yoshioka
- Department of HematologyKobe City Medical Center General HospitalKobeJapan
| | - Daishi Nakagawa
- Department of HematologyKobe City Medical Center General HospitalKobeJapan
| | - Kohei Hasegawa
- Department of Infectious DiseasesKobe City Medical Center General HospitalKobeJapan
| | - Hirokazu Kuroda
- Department of Infectious DiseasesKobe City Medical Center General HospitalKobeJapan
| | - Toshikazu Hasuike
- Department of Infectious DiseasesKobe City Medical Center General HospitalKobeJapan
| | - Asako Doi
- Department of Infectious DiseasesKobe City Medical Center General HospitalKobeJapan
| | - Toshiko Kusumoto
- Department of Clinical LaboratoryKobe City Medical Center General HospitalKobeJapan
| | - Takayuki Ishikawa
- Department of HematologyKobe City Medical Center General HospitalKobeJapan
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20
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Nishikubo M, Shimomura Y, Maruoka H, Nasu S, Nishioka T, Sakizono K, Mitsuyuki S, Kubo T, Okada N, Nakagawa D, Kamijo K, Imoto H, Yamamoto R, Nagai Y, Hiramoto N, Yoshioka S, Yonetani N, Matsushita A, Miyakoshi C, Doi A, Ishikawa T. Humoral response and safety of the BNT162b2 and mRNA-1273 COVID-19 vaccines in patients with haematological diseases treated with anti-CD20 antibodies: An observational study. Br J Haematol 2022; 197:709-713. [PMID: 35262920 PMCID: PMC9111764 DOI: 10.1111/bjh.18151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 03/07/2022] [Accepted: 03/08/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Masashi Nishikubo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Yoshimitsu Shimomura
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan.,Department of Environmental Medicine and Population Science, Graduate School of Medicine, Osaka University, Osaka, 565-0871, Japan
| | - Hayato Maruoka
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Seiko Nasu
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Tomomi Nishioka
- LSI Medience Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Kenji Sakizono
- Department of Clinical Laboratory, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Satoshi Mitsuyuki
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Tomoyo Kubo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Naoki Okada
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Daishi Nakagawa
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Kimimori Kamijo
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Hiroharu Imoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Ryusuke Yamamoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Yuya Nagai
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Nobuhiro Hiramoto
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Satoshi Yoshioka
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Noboru Yonetani
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Akiko Matsushita
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Chisato Miyakoshi
- Department of Research Support, Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Asako Doi
- Department of Infectious diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
| | - Takayuki Ishikawa
- Department of Hematology, Kobe City Medical Center General Hospital, Kobe, Hyogo, 650-0047, Japan
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21
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Masumoto A, Kitai T, Matsumoto S, Kuroda S, Kohsaka S, Tachikawa R, Seo R, Doi A, Tomii K, Yonetsu T, Torii S, Komuro I, Hirata KI, Node K, Matsue Y, Furukawa Y. Impact of serum lactate dehydrogenase on the short-term prognosis of COVID-19 with pre-existing cardiovascular diseases. J Cardiol 2021; 79:501-508. [PMID: 35000825 PMCID: PMC8712257 DOI: 10.1016/j.jjcc.2021.12.014] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 11/28/2021] [Accepted: 12/19/2021] [Indexed: 12/25/2022]
Abstract
Background Patients with coronavirus disease 2019 (COVID-19) and underlying cardiovascular comorbidities have poor prognoses. Our aim was to identify the impact of serum lactate dehydrogenase (LDH), which is associated with mortality in acute respiratory distress syndrome, on the prognoses of patients with COVID-19 and underlying cardiovascular comorbidities. Methods Among 1518 patients hospitalized with COVID-19 enrolled in the CLAVIS-COVID (Clinical Outcomes of COVID-19 Infection in Hospitalized Patients with Cardiovascular Diseases and/or Risk Factors study), 515 patients with cardiovascular comorbidities were analyzed. Patients were divided into tertiles based on LDH levels at admission [tertile 1 (T1), <235 U/L; tertile 2 (T2), 235–355 U/L; and tertile 3 (T3); ≥356 U/L]. We investigated the impact of LDH levels on the in-hospital mortality. Results The mean age was 70.4 ± 30.0 years, and 65.3% were male. There were significantly more in-hospital deaths in T3 than in T1 and T2 [n = 50 (29.2%) vs. n = 15 (8.7%), and n = 24 (14.0%), respectively; p < 0.001]. Multivariable analysis adjusted for age, comorbidities, vital signs, and laboratory data including D-dimer and high-sensitivity troponin showed T3 was associated with an increased risk of in-hospital mortality (adjusted hazard ratio, 3.04; 95% confidence interval, 1.50–6.13; p = 0.002). Conclusions High serum LDH levels at the time of admission are associated with an increased risk of in-hospital death in patients with COVID-19 and known cardiovascular disease and may aid in triage of these patients.
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Affiliation(s)
- Akiko Masumoto
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan; Division of Cardiovascular Medicine, Hyogo Brain and Heart Center, Himeji, Japan
| | - Takeshi Kitai
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan; Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Medicine Center, 6-1 Kishibe-shinmachi, Osaka, Japan.
| | - Shingo Matsumoto
- Department of Cardiovascular Medicine, Department of Internal Medicine, Toho University Faculty of Medicine, Tokyo, Japan
| | - Shunsuke Kuroda
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States
| | - Shun Kohsaka
- Department of Cardiology, Keio University School of Medicine, Tokyo, Japan
| | - Ryo Tachikawa
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Ryutaro Seo
- Department of Intensive Care, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Asako Doi
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Taishi Yonetsu
- Department of Interventional Cardiology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Sho Torii
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Ken-Ichi Hirata
- Department of Internal Medicine, Division of Cardiovascular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Saga, Japan
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yutaka Furukawa
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital, Kobe, Japan
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22
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Doi A, Iwata K, Kuroda H, Hasuike T, Nasu S, Nishioka H, Tomii K, Morimoto T, Kihara Y. A cross-sectional follow up study to estimate seroprevalence of coronavirus disease 2019 in Kobe, Japan. Medicine (Baltimore) 2021; 100:e28066. [PMID: 35049228 PMCID: PMC9191319 DOI: 10.1097/md.0000000000028066] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 11/09/2021] [Indexed: 11/26/2022] Open
Abstract
We conducted a study to estimate the seroprevalence of coronavirus disease 2019 (COVID-19) in Kobe, Japan with positive immunoglobulin G (IgG) rate of 3.3% (95% confidence interval [CI] 2.3%-4.6%) in April 2020. Because there were large concerns about the spread of COVID-19 among citizens thereafter, we conduct a follow-up cross-sectional study to estimate the seroprevalence, and we also added a validation study using a different assay.We conducted cross-sectional serologic testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody using 1000 samples from patients at outpatient settings who visited the clinic from May 26 to June 7, 2020, stratified by the decade of age and sex. We used both Kurabo and Abbott serology assays to identify IgG against SARS-CoV-2.There were 18 and 2 positive IgG among 1000 serum samples using Kurabo and Abbott serology assays, respectively (1.8%, 95% CI 1.1%-2.8%, and 0.2%, 95% CI 0.02%-0.7% respectively). By applying the latter figure to the census of Kobe City (population: 1,518,870), it is estimated that the number of people with positive IgG is 3038 (95% CI: 304-10,632) while a total of 285 patients were identified by polymerase chain reaction (PCR) testing at the end of the study period. Assuming Abbott assay as the reference, Kurabo assay had calculated sensitivity and specificity of 100% and 98.4% respectively. Age and sex adjusted prevalence of positivity was calculated to be 0.17%.We found a lower seroprevalence than 2 months before in Kobe city although the figures were still higher than those detected by PCR. Kurabo assay showed more false positives than true positives despite reasonable sensitivity and specificity, due to low prevalence in Kobe.
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Affiliation(s)
- Asako Doi
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Kentaro Iwata
- Division of Infectious Diseases Therapeutics, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan
| | - Hirokazu Kuroda
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Toshikazu Hasuike
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Seiko Nasu
- Department of Laboratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Hiroaki Nishioka
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo Medical College, Nishinomiya, Hyogo, Japan
| | - Yasuki Kihara
- Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
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23
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Yamamoto H, Oikawa R, Takeda H, Umemoto K, Doi A, Horie Y, Ogura T, Mizukami T, Izawa N, Moore J, Sokol E, Sunakawa Y. 1423P Genomic landscape in advanced gastric cancer from real-world data (RWD) of clinical genomic testing. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1532] [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: 10/20/2022] Open
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24
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Doi A, Iwata K, Kuroda H, Hasuike T, Nasu S, Kanda A, Nagao T, Nishioka H, Tomii K, Morimoto T, Kihara Y. Estimation of seroprevalence of novel coronavirus disease (COVID-19) using preserved serum at an outpatient setting in Kobe, Japan: A cross-sectional study. Clin Epidemiol Glob Health 2021; 11:100747. [PMID: 33898863 PMCID: PMC8053595 DOI: 10.1016/j.cegh.2021.100747] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 04/12/2021] [Indexed: 12/24/2022] Open
Abstract
Objectives Coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 has been affecting many people on earth and our society. Japan is known to have relatively smaller number of its infections as well as deaths among developed nations. However, accurate prevalence of COVID-19 in Japan remains unknown. Therefore, we conducted a cross-sectional study to estimate seroprevalence of SARS-CoV-2 infection. Methods We conducted a cross-sectional serologic testing for SARS-CoV-2 antibody using 1000 samples from patients at outpatient settings who visited the clinic from March 31 to April 7, 2020, stratified by the decade of age and sex. Results There were 33 positive IgG among 1000 serum samples (3.3%, 95%CI: 2.3–4.6%). By applying this figure to the census of Kobe City (population: 1,518,870), it is estimated that the number of people with positive IgG be 50,123 (95%CI: 34,934–69,868). Age and sex adjusted prevalence of positivity was calculated 2.7% (95%CI: 1.8–3.9%), and the estimated number of people with positive IgG was 40,999 (95%CI: 27,333–59,221). These numbers were 396 to 858-fold more than confirmed cases with PCR testing in Kobe City. Conclusions Our cross-sectional serological study suggests that the number of people with seropositive for SARS-CoV-2 infection in Kobe, Japan is far more than the confirmed cases by PCR testing.
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Affiliation(s)
- Asako Doi
- Department of Infection Control, Kobe City Medical Center General Hospital, Chuoku, 6500047, Kobe, Hyogo, Japan.,Department of Infectious Diseases, Kobe City Medical Center General Hospital, Chuoku, 6500047, Kobe, Hyogo, Japan
| | - Kentaro Iwata
- Division of Infectious Diseases Therapeutics, Kobe University Graduate School of Medicine, Chuoku, 6500017, Kobe, Hyogo, Japan
| | - Hirokazu Kuroda
- Department of Infection Control, Kobe City Medical Center General Hospital, Chuoku, 6500047, Kobe, Hyogo, Japan.,Department of Infectious Diseases, Kobe City Medical Center General Hospital, Chuoku, 6500047, Kobe, Hyogo, Japan
| | - Toshikazu Hasuike
- Department of Infection Control, Kobe City Medical Center General Hospital, Chuoku, 6500047, Kobe, Hyogo, Japan.,Department of Infectious Diseases, Kobe City Medical Center General Hospital, Chuoku, 6500047, Kobe, Hyogo, Japan
| | - Seiko Nasu
- Department of Infection Control, Kobe City Medical Center General Hospital, Chuoku, 6500047, Kobe, Hyogo, Japan.,Department of Laboratory Medicine, Kobe City Medical Center General Hospital, Chuokum, 6500047, Kobe, Hyogo, Japan
| | - Aya Kanda
- Department of Laboratory Medicine, Kobe City Medical Center General Hospital, Chuokum, 6500047, Kobe, Hyogo, Japan
| | - Tomomi Nagao
- Department of Laboratory Medicine, Kobe City Medical Center General Hospital, Chuokum, 6500047, Kobe, Hyogo, Japan
| | - Hiroaki Nishioka
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Chuoku, 6500047, Kobe, Hyogo, Japan
| | - Keisuke Tomii
- Department of Respiratory Medicine, Kobe City Medical Center General Hospital, Chuoku, 6500047, Kobe, Hyogo, Japan
| | - Takeshi Morimoto
- Department of Clinical Epidemiology, Hyogo Medical College, Mukogawa, 6638501, Nishinomiya, Hyogo, Japan
| | - Yasuki Kihara
- Kobe City Medical Center General Hospital, Chuoku, 6500047, Kobe, Hyogo, Japan
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25
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Tsuji T, Hiroyuki A, Uraki S, Doi A, Morita S, Iwakura H, Nishi M, Furuta H, Akamizu T. Autosomal Dominant Hypocalcemia With Atypical Urine Findings Accompanied by Novel CaSR Gene Mutation and VitD Deficiency. J Endocr Soc 2021; 5:bvaa190. [PMID: 33506158 PMCID: PMC7814383 DOI: 10.1210/jendso/bvaa190] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction Autosomal dominant hypocalcemia (ADH) is caused by gain-of-function mutations of the calcium sensing receptor (CaSR). It is characterized by hypercalciuria in spite of hypocalcemia. Vitamin D deficiency increases calcium reabsorption in the distal tubules of the kidneys, resulting in hypocalciuria. Materials and methods A 38-year-old female proband had hypocalcemia, hypocalciuria, and vitamin D deficiency. Her father and brother also had hypocalcemia, but her mother was normocalcemic. We analyzed the CaSR gene abnormality in this family. Polymerase chain reaction (PCR) and sequence analysis were performed to explore the CaSR gene mutation. Mutagenesis, transfection, and functional analysis were performed on the discovered genetic abnormalities. Result PCR and sequence analysis revealed that the proband, her father, and brother had a novel heterozygous mutation of the CaSR genes that causes threonine to asparagine substitution at codon 186 (T186N). Using HEK293 cells transfected with wild-type or T186N CaSR complementary DNA, we assessed the intracellular Ca2+ concentration in response to changes in the extracellular Ca2+ concentration. The cells transfected mutant CaSR gene had higher activity than that of wild-type. Therefore, we determined our patient had ADH with a novel mutation of the CaSR gene and hypocalciuria resulting from a vitamin D deficiency. We administered vitamin D to the proband, which caused elevation of her urinary calcium level, a typical finding of ADH. Conclusion Vitamin D deficiency was suggested to potentially mask hypercalciuria in ADH. Hypocalcemia with vitamin D deficiency should be diagnosed with care.
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Affiliation(s)
- Tomoya Tsuji
- First Department of Medicine, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
| | - Ariyasu Hiroyuki
- First Department of Medicine, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
| | - Shinsuke Uraki
- First Department of Medicine, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
| | - Asako Doi
- First Department of Medicine, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
| | - Shuhei Morita
- First Department of Medicine, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
| | - Hiroshi Iwakura
- First Department of Medicine, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
| | - Masahiro Nishi
- First Department of Medicine, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
| | - Hiroto Furuta
- First Department of Medicine, Wakayama Medical University, Wakayama, Wakayama Prefecture, Japan
| | - Takashi Akamizu
- Internal Medicine, Kuma Hospital, Chuo-ku, Kobe, Hyogo Prefecture, Japan
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26
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Lovelock T, Cheng A, Doi A, Zimmet A, Gooi J, Fitzgerald M. Blunt bronchial injury management with veno-venous extracorporeal membrane oxygenation providing a peri-operative 'survival bridge'. Trauma Case Rep 2020; 31:100388. [PMID: 33364296 PMCID: PMC7750647 DOI: 10.1016/j.tcr.2020.100388] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- T Lovelock
- Department of Cardiothoracic Surgery, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - A Cheng
- Department of Cardiothoracic Surgery, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - A Doi
- Department of Cardiothoracic Surgery, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - A Zimmet
- Department of Cardiothoracic Surgery, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - J Gooi
- Department of Cardiothoracic Surgery, Alfred Hospital, Melbourne, VIC 3004, Australia
| | - M Fitzgerald
- Trauma Service, The Alfred Hospital, Melbourne, Australia
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27
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Takeshima K, Ariyasu H, Uraki S, Morita S, Furukawa Y, Inaba H, Iwakura H, Doi A, Warigaya K, Murata SI, Enomoto K, Hotomi M, Akamizu T. False-positive staining of thyroglobulin distinguished from mixed medullary and follicular thyroid carcinoma by duplex in situ hybridization. Endocr J 2020; 67:1007-1017. [PMID: 32522910 DOI: 10.1507/endocrj.ej20-0169] [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] [Indexed: 11/23/2022] Open
Abstract
Medullary thyroid carcinoma (MTC) may mimic mixed medullary and follicular thyroid carcinoma (MMFTC). MTC originates from para-follicular cells, while MMFTC is an uncommon tumor characterized by coexistence of follicular and para-follicular cell-derived tumor populations. A 35-year-old woman was diagnosed with MTC but showed a hot nodule in thyroid scintigraphy. The tumor included diffusely-spread follicular lesions within it, which were immunostained with thyroglobulin and calcitonin. Immunofluorescence showed the presence of several tumor cells that were double-stained with thyroglobulin and calcitonin. To clarify whether or not the tumor was MMFTC, we used duplex in situ hybridization (ISH). Thyroglobulin and calcitonin-related polypeptide alpha mRNA were not expressed together in a single cell, so we suspected false-positive staining of tumor cells with thyroglobulin. To make comparisons with other follicular lesions in MTC, we searched our hospital database. Five cases within a ten-year period had been pathologically diagnosed as MTC. All had follicular lesions in the tumor, but unlike the other case, they were peripherally localized. Dual differentiation into follicular or para-follicular tumor cells was not indicated by either immunofluorescence or duplex ISH. Compared with the case suspected to be MMFTC, there was only mild invasion of tumor cells into the follicular epithelium. The extent of follicular lesions and invasiveness of tumor cells may be associated with pseudo-staining of thyroglobulin in MTC. Duplex ISH can distinguish MTC that are stained with thyroglobulin from MMFTC.
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MESH Headings
- Adenocarcinoma, Follicular/diagnosis
- Adenocarcinoma, Follicular/metabolism
- Adenocarcinoma, Follicular/pathology
- Adult
- Aged
- Calcitonin/metabolism
- Carcinoma, Neuroendocrine/diagnosis
- Carcinoma, Neuroendocrine/metabolism
- Carcinoma, Neuroendocrine/pathology
- Diagnosis, Differential
- False Positive Reactions
- Female
- Humans
- In Situ Hybridization
- Male
- Middle Aged
- Mixed Tumor, Malignant/diagnosis
- Mixed Tumor, Malignant/metabolism
- Mixed Tumor, Malignant/pathology
- Neoplasm Invasiveness
- Procalcitonin/metabolism
- RNA, Messenger/metabolism
- Radionuclide Imaging
- Thyroglobulin/metabolism
- Thyroid Neoplasms/diagnosis
- Thyroid Neoplasms/metabolism
- Thyroid Neoplasms/pathology
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Affiliation(s)
- Ken Takeshima
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Hiroyuki Ariyasu
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Shinsuke Uraki
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Shuhei Morita
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Yasushi Furukawa
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Hidefumi Inaba
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Hiroshi Iwakura
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Asako Doi
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Kenji Warigaya
- Department of Human Pathology, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Shin-Ichi Murata
- Department of Human Pathology, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Keisuke Enomoto
- Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Muneki Hotomi
- Department of Otolaryngology-Head and Neck Surgery, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Takashi Akamizu
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
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Doi A, Hasuike T, Shindo T, Nishioka H. Elevation of CSF adenosine deaminase in HIV patient with meningitis from retroviral rebound syndrome, a case report. Int J Infect Dis 2020; 98:297-298. [PMID: 32562847 DOI: 10.1016/j.ijid.2020.06.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 06/10/2020] [Accepted: 06/13/2020] [Indexed: 11/18/2022] Open
Abstract
Adenosine deaminase (ADA) in cerebrospinal fluid (CSF) is considered to be a useful biomarker in differentiating tuberculous meningitis (TBM) from other meningitis in non-HIV patients. However, its specificity decreases in patients with HIV, and other diseases such as cytomegalovirus encephalitis, toxoplasmosis or meningeal lymphomatosis can also elevate ADA in CSF. We here report a rare case of retroviral rebound syndrome in a HIV patient, whose ADA in CSF was elevated.
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Affiliation(s)
- Asako Doi
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Japan; Department of General Internal Medicine, Kobe City Medical Center General Hospital, Japan.
| | - Toshikazu Hasuike
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Japan; Department of General Internal Medicine, Kobe City Medical Center General Hospital, Japan
| | - Tatsuya Shindo
- Department of General Internal Medicine, Kobe City Medical Center General Hospital, Japan
| | - Hiroaki Nishioka
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Japan; Department of General Internal Medicine, Kobe City Medical Center General Hospital, Japan
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29
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Inagaki Y, Takeshima K, Nishi M, Ariyasu H, Doi A, Kurimoto C, Uraki S, Morita S, Furukawa Y, Inaba H, Iwakura H, Shimokawa T, Utsunomiya T, Akamizu T. The influence of thyroid autoimmunity on pregnancy outcome in infertile women: a prospective study. Endocr J 2020; 67:859-868. [PMID: 32336697 DOI: 10.1507/endocrj.ej19-0604] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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] [Indexed: 11/23/2022] Open
Abstract
Thyroid dysfunction and thyroid autoimmunity (TAI) have been reported to be linked to infertility, pregnancy loss and preterm birth. Infertile women undergoing assisted reproductive technology are recommended to maintain thyroid stimulating hormone (TSH) levels below 2.5 μIU/mL. It is unclear, however, whether levothyroxine (L-T4) treatment decreases the effects of TAI on fertility and pregnancy outcome in infertile women. We therefore aimed to clarify the influence of TAI on pregnancy undergoing L-T4 treatment for hypothyroidism. Prospectively recruited to this study were the 595 infertile women who visited the Utsunomiya Ladies Clinic between January 2013 and December 2015. Five patients with Graves' disease were excluded. Clinical profiles of 590 women were as follows: proportion of SCH = 19.6%, thyroid peroxidase antibody (TPOAb) positivity = 10.4%, and thyroglobulin antibody (TgAb) positivity = 15.1%. Fertility was not affected by any thyroid-associated factors. Regarding pregnancy outcomes, TPOAb titers were significantly higher in women who had miscarriage than in those progressed to delivery (46.4 ± 114.1 vs. 18.9 ± 54.6 IU/mL, p = 0.039), notably in those undergoing intrauterine insemination (p = 0.046) and in vitro fertilization (p = 0.023). Multivariate logistic regression analysis revealed that higher age (odds ratio 26.4, p < 0.001) and higher TPOAb titer (odds ratio 11.8, p = 0.043) were risk factors for miscarriage. Higher TPOAb titer should be considered as one of the risk factors for miscarriage in infertile women, even if they have been treated with L-T4 for hypothyroidism.
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Affiliation(s)
- Yuko Inagaki
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Ken Takeshima
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Masahiro Nishi
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
- Division of Clinical Nutrition and Metabolism, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Hiroyuki Ariyasu
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Asako Doi
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Chiaki Kurimoto
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Shinsuke Uraki
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Shuhei Morita
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Yasushi Furukawa
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Hidefumi Inaba
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Hiroshi Iwakura
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
| | - Toshio Shimokawa
- Clinical Study Support Center, Wakayama Medical University, Wakayama 641-8509, Japan
| | | | - Takashi Akamizu
- First Department of Internal Medicine, Wakayama Medical University, Wakayama 641-8509, Japan
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Iwata K, Doi A, Miyakoshi C. Was school closure effective in mitigating coronavirus disease 2019 (COVID-19)? Time series analysis using Bayesian inference. Int J Infect Dis 2020; 99:57-61. [PMID: 32745628 PMCID: PMC7836901 DOI: 10.1016/j.ijid.2020.07.052] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [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: 06/26/2020] [Revised: 07/21/2020] [Accepted: 07/26/2020] [Indexed: 12/19/2022] Open
Abstract
The effectiveness of school closure to mitigate the epidemic of COVID-19 remains unknown. Time series analyses were conducted using the Bayesian method to evaluate the effectiveness of school closure in Japan. The intervention of school closure did not appear to decrease the incidence of coronavirus infection.
Objectives The Coronavirus disease 2019 (COVID-19) pandemic is causing significant damage to many nations. For mitigating its risk, Japan called on all elementary, junior high, and high schools nationwide to close beginning March 1, 2020. However, its effectiveness in decreasing the disease burden has not been investigated. Methods We used daily data of the COVID-19 and coronavirus infection incidence in Japan until March 31, 2020. Time-series analyses were conducted using the Bayesian method. Local linear trend models with interventional effects were constructed for the number of newly reported cases of COVID-19, including asymptomatic infections. We considered that the effects of the intervention started to appear nine days after the school closure. Results The intervention of school closure did not appear to decrease the incidence of coronavirus infection. If the effectiveness of school closure began on March 9, the mean coefficient α for the effectiveness of the measure was calculated to be 0.08 (95% confidence interval −0.36 to 0.65), and the actual reported cases were more than predicted, yet with a rather wide confidence interval. Sensitivity analyses using different dates also did not demonstrate the effectiveness of the school closure. Discussion School closure carried out in Japan did not show any mitigating effect on the transmission of novel coronavirus infection.
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Affiliation(s)
- Kentaro Iwata
- Division of Infectious Diseases, Kobe University Hospital, 7-5-2 Kusunokicho, Chuoku, Kobe, Hyogo 650-0017, Japan.
| | - Asako Doi
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamicho, Chuoku, Kobe, Hyogo 650-0047, Japan.
| | - Chisato Miyakoshi
- Department of Research Support, Center for Clinical Research and Innovation, Kobe City Medical Center General Hospital, 2-1-1 Minatojimaminamicho, Chuoku, Kobe, Hyogo 650-0047, Japan.
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Nishikubo M, Doi A, Takegawa H, Yamashita D, Ohira J, Nishioka H. Asymptomatic pulmonary penicilliosis with a lung mass in an HIV-infected patient. J Gen Fam Med 2020; 21:152-154. [PMID: 32742907 PMCID: PMC7388672 DOI: 10.1002/jgf2.325] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 03/24/2020] [Accepted: 04/14/2020] [Indexed: 12/28/2022] Open
Abstract
Penicillium marneffei (Talaromyces marneffei) infection sometimes occurs in HIV-infected patients in South-East Asia. However, reports on asymptomatic cases are rare. Herein, we report a case of a 27-year-old Burmese HIV-positive woman with pulmonary penicilliosis. Chest radiography showed a lung mass; however, the patient did not have any respiratory symptoms. Cultures of bronchoalveolar lavage and lung tissue grew P marneffei. The patient was diagnosed with penicilliosis and successfully treated with amphotericin B and itraconazole. Our findings suggest that P marneffei infection should be considered in the differential diagnosis of a lung mass in HIV-infected patients, even when asymptomatic for respiratory symptoms.
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Affiliation(s)
- Masashi Nishikubo
- Department of General Internal MedicineKobe City Medical Center General HospitalKobeJapan
| | - Asako Doi
- Department of General Internal MedicineKobe City Medical Center General HospitalKobeJapan
- Department of Infectious DiseaseKobe City Medical Center General HospitalKobeJapan
| | - Hiroshi Takegawa
- Department of Laboratory MedicineKobe City Medical Center General HospitalKobeJapan
| | - Daisuke Yamashita
- Department of PathologyKobe City Medical Center General HospitalKobeJapan
| | - Junichiro Ohira
- Department of NeurologyKobe City Medical Center General HospitalKobeJapan
| | - Hiroaki Nishioka
- Department of General Internal MedicineKobe City Medical Center General HospitalKobeJapan
- Department of Infectious DiseaseKobe City Medical Center General HospitalKobeJapan
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32
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Morita S, Takeshima K, Ariyasu H, Furukawa Y, Kishimoto S, Tsuji T, Uraki S, Mishima H, Kinoshita A, Takahashi Y, Inaba H, Iwakura H, Furuta H, Nishi M, Doi A, Murata SI, Yoshiura KI, Akamizu T. Expression of unfolded protein response markers in the pheochromocytoma with Waardenburg syndrome: a case report. BMC Endocr Disord 2020; 20:90. [PMID: 32571297 PMCID: PMC7309974 DOI: 10.1186/s12902-020-00574-9] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 06/11/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It is clinically emergent to further understand the pathological mechanism to advance therapeutic strategy for endocrine tumors. A high amount of secretory protein with tumorigenic triggers are thought to induce unfolded protein response in endoplasmic reticulum in endocrine tumors, but its evidence is limited. CASE PRESENTATION A 40-year-old woman had an approximately 10-year history of intermittent headaches. After the incidental detection of a mass in her right adrenal gland by CT scan, she was admitted to our hospital. She had been diagnosed as type 1 Waardenburg syndrome with the symptoms of dystopia canthorum, blue iris, and left sensorineural hearing loss. Urinary catecholamine levels were markedly elevated. 123I-MIBG scintigraphy showed uptake in the mass in her adrenal gland. After the adrenalectomy, her headaches disappeared and urinary catecholamine levels decreased to normal range within 2 weeks. Genome sequencing revealed germline mutation of c.A175T (p.Ile59Phe) in transcription factor PAX3 gene and somatic novel mutation of c.1893_1898del (p. Asp631_Leu633delinsGlu) in proto-oncogene RET in her pheochromocytoma. RNA expression levels of RET were increased 139 times in her pheochromocytoma compared with her normal adrenal gland. Those of unfolded protein response markers, Bip/GRP78, CHOP, ATF4, and ATF6, were also increased in the pheochromocytoma. CONCLUSION We report a rare case of pheochromocytoma with type 1 Waardenburg syndrome. This is the first case to show the activation of unfolded protein response in the pheochromocytoma with the novel somatic mutation in RET gene. Our findings may support that unfolded protein response is activated in endocrine tumors, which potentially could be a candidate of therapeutic target.
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Affiliation(s)
- Shuhei Morita
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimi-idera, Wakayama, Wakayama, 641-8509, Japan.
| | - Ken Takeshima
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimi-idera, Wakayama, Wakayama, 641-8509, Japan
| | - Hiroyuki Ariyasu
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimi-idera, Wakayama, Wakayama, 641-8509, Japan
| | - Yasushi Furukawa
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimi-idera, Wakayama, Wakayama, 641-8509, Japan
| | - Shohei Kishimoto
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimi-idera, Wakayama, Wakayama, 641-8509, Japan
| | - Tomoya Tsuji
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimi-idera, Wakayama, Wakayama, 641-8509, Japan
| | - Shinsuke Uraki
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimi-idera, Wakayama, Wakayama, 641-8509, Japan
| | - Hiroyuki Mishima
- Department of Human Genetics, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Akira Kinoshita
- Department of Human Genetics, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Yuichi Takahashi
- Department of Diagnostic Pathology, Wakayama Medical University, Wakayama, Japan
| | - Hidefumi Inaba
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimi-idera, Wakayama, Wakayama, 641-8509, Japan
| | - Hiroshi Iwakura
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimi-idera, Wakayama, Wakayama, 641-8509, Japan
| | - Hiroto Furuta
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimi-idera, Wakayama, Wakayama, 641-8509, Japan
| | - Masahiro Nishi
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimi-idera, Wakayama, Wakayama, 641-8509, Japan
| | - Asako Doi
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimi-idera, Wakayama, Wakayama, 641-8509, Japan
| | - Shin-Ichi Murata
- Department of Diagnostic Pathology, Wakayama Medical University, Wakayama, Japan
| | - Koh-Ichiro Yoshiura
- Department of Human Genetics, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, Japan
| | - Takashi Akamizu
- The First Department of Medicine, Wakayama Medical University, 811-1 Kimi-idera, Wakayama, Wakayama, 641-8509, Japan
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Ueda Y, Iwakura H, Doi A, Matsutani N, Morita S, Inaba H, Ariyasu H, Fukuda N, Hayata K, Ojima T, Nishi M, Yamaue H, Akamizu T. MON-603 GPR142 Expression Levels Were Correlated with Plasma Ghrelin Levels and Heights in Morbidly Obese Patients. J Endocr Soc 2020. [PMCID: PMC7209712 DOI: 10.1210/jendso/bvaa046.583] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Recently, aromatic amino acids, especially tryptophan were discovered to be the strongest ligands for GPR142, which was previously known as an orphan GPCR. GPR142 is expressed in the digestive tract and pancreas in mice and human. Previously we found that GPR142 is highly expressed in the ghrelin-producing cell line, MGN3-1 cells, and that tryptophan strongly stimulated ghrelin secretion in vitro. In this study, we measured the mRNA expression levels of GPR142 in the gastric samples of 6 morbid obese patients undergone laparoscopic sleeve gastrectomy and compared its level with their clinical parameters. GPR142 expression levels were negatively correlated with plasma desacyl ghrelin levels (p=0.011) and positively correlated with heights (p=0.08). The current results that GPR142 expression levels were correlated with plasma desacyl ghrelin levels may confirm the link between GPR142 signal and regulation of ghrelin secretion demonstrated in our in vitro study. Regarding to the correlation with heights, there are some reports that plasma ghrelin levels were inversely correlated with heights in children[1-3], although, as far as we know, there are no reports demonstrating the relationship between plasma ghrelin levels and heights in adults. Considering that ghrelin strongly stimulates growth hormone secretion, GPR142 signaling may have influence on height through regulating ghrelin-growth hormone axis. Conclusion GPR142 mRNA expression levels were negatively and positively correlated with plasma desacyl ghrelin levels and heights in morbid obese adults undergone bariatric surgery. Current results may help understanding the pathophysiological role of GPR142 in the regulation of ghrelin secretion and heights. References 1. MO Camurdan, et al. Endocrine Journal 2006, 53 (4), 479–484 2. HS Park, et al. Metabolism Clinical and Experimental 2005, 54, 925–929 3. Joy C. Bunt,et al. J Clin Endocrinol Metab 2003, 88(8): 3756-3761
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Affiliation(s)
- Yoko Ueda
- Wakayama Medical University, Wakayama, Japan
| | | | - Asako Doi
- Wakayama Medical University, Wakayama, Japan
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Uraki S, Ariyasu H, Doi A, Takeshima K, Morita S, Fukuhara N, Inoshita N, Nishioka H, Nakao N, Yamada S, Akamizu T. SAT-301 Relationship Between Clinicopathological Aspects and MSH6/MSH2 and PD-L1 Expressions in Clinically Nonfunctioning Pituitary Adenomas. J Endocr Soc 2020. [PMCID: PMC7208038 DOI: 10.1210/jendso/bvaa046.129] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Introduction: Mismatch repair (MMR) genes are associated with the MMR mechanism that corrects DNA polymerase misincorporation errors. We analyzed the aggressive pituitary adenomas (PAs) associated with Lynch syndrome due to germline mutation in the MMR gene. Reduced expression of MMR genes mutS homologs 6/2 (MSH6/2) directly promotes PA growth (1, 2). MMR gene expression and programmed cell death 1 ligand 1 (PD-L1) expression are involved in tumor immunity with immune checkpoint inhibitors, but the direct association in PAs is not fully understood. Hypothesis and Objectives: MSH6/2 and PD-L1 expression could affect PA proliferation and invasion by pathological classification of nonfunctioning (NF) PAs because the proliferation and invasiveness differ depending on the PA histological subtype. In this study, we therefore analyzed the correlation between MSH6/2 and PD-L1 mRNA expression levels and clinicopathological factors related to tumor proliferation using human NFPAs. Experimental Design: We performed immunohistochemistry to classify the NFPAs into gonadotroph adenomas (GAs), silent corticotroph adenomas (SCAs), null cell adenomas (NCAs) and pituitary transcription factor 1 (PIT1) lineage PAs according to 2017 WHO classifications. Quantitative analyses were by real-time PCR to detect MSH6/2 and PD-L1 mRNA expressions in NFPAs (n = 89). We also performed statistical analyses of the expressions and clinicopathological factors such as Knosp Grade and histological subtypes. We investigated the effect of MSH6 knockout on cell proliferation and PD-L1 expression in AtT-20ins cells. Major Results: MSH6/2 expression was positively associated with PD-L1 expression. MSH6/2 and PD-L1 expressions are significantly lower in invasive NFPAs with Knosp Grade 3–4 or recurrence than in non-invasive NFPAs with Knosp Grade 1–2. Their expression is significantly lower in SCAs and NCAs than in GAs. Although MSH6/2 expression also tends to be lower, the PD-L1 expression tends to be higher in PIT1 lineage PAs, which is unlike SCAs and NCAs. MSH6 knockout in AtT-20ins significantly decreased PD-L1 expression with cell proliferation promotion. Interpretation of results and Conclusion: MSH6/2 and PD-L1 expressions of SCAs, NCAs, and PIT1 lineage PAs compared to GAs were thought to contribute to their clinically aggressive behaviors. The molecular mechanism of the difference in clinical features of NFPAs was partially elucidated. In particular, reduced expressions of MSH6/2 were thought to be useful for predicting the proliferation and invasiveness of NFPAs. References: (1) Uraki S et al., Endocr J. 2017;64(9):895–906 (2) Uraki S et al., J Clin Endocrinol Metab. 2018;103(3):1171–1179. Declarations of conflicts of Interest: No authors declare any conflicts of interest.
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Affiliation(s)
- Shinsuke Uraki
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiroyuki Ariyasu
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Asako Doi
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Ken Takeshima
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Shuhei Morita
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Noriaki Fukuhara
- Department of Hypothalamic and Pituitary Surgery, Toranomon Hospital, Tokyo, Japan
| | - Naoko Inoshita
- Department of Pathology, Tokyo Metropolitan Geriatric Medical Center, Tokyo, Japan
| | - Hiroshi Nishioka
- Department of Hypothalamic and Pituitary Surgery, Toranomon Hospital, Tokyo, Japan
| | - Naoyuki Nakao
- Department of Neurological Surgery, Wakayama Medical University, Wakayama, Japan
| | - Shozo Yamada
- Hypothalamic and Pituitary Center, Moriyama Neurological Center Hospital,, Tokyo, Japan
| | - Takashi Akamizu
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
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Uraki S, Furuta H, Miyawaki M, Matsutani N, Shima Y, Iwamoto M, Matsuno S, Morita S, Furuta M, Doi A, Iwakura H, Ariyasu H, Nishi M, Suzuki H, Akamizu T. Neonatal diabetes caused by the heterozygous Pro1198Leu mutation in the ABCC8 gene in a male infant: 6-year clinical course. J Diabetes Investig 2020; 11:502-505. [PMID: 31390154 PMCID: PMC7078085 DOI: 10.1111/jdi.13127] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/01/2019] [Accepted: 08/05/2019] [Indexed: 01/17/2023] Open
Abstract
Neonatal diabetes is a rare disease, often caused by a monogenic abnormality. A male infant patient developed diabetic ketoacidosis at 2 months-of-age due to the heterozygous ABCC8 gene mutation (p.Pro1198Leu). After genetic diagnosis, insulin therapy was successfully transitioned to oral sulfonylurea therapy. For >6 years, oral sulfonylurea therapy has been safe and effective, and the required amount of sulfonylureas has progressively decreased. The mutation was transmitted in an autosomal-dominant fashion across three generations of his family, but the severity of diabetes varied among members from neonatal diabetes to mild diabetes. One family member had normal glucose tolerance despite having the mutation. This case presentation could help in the understanding of neonatal diabetes caused by the ABCC8 gene mutation.
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Affiliation(s)
- Shinsuke Uraki
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Hiroto Furuta
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | | | - Norihiko Matsutani
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Yuko Shima
- Department of PediatricsWakayama Medical UniversityWakayamaJapan
| | - Miki Iwamoto
- Department of PediatricsWakayama Medical UniversityWakayamaJapan
| | - Shohei Matsuno
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Shuhei Morita
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Machi Furuta
- Clinical Laboratory MedicineWakayama Medical UniversityWakayamaJapan
| | - Asako Doi
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Hiroshi Iwakura
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Hiroyuki Ariyasu
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Masahiro Nishi
- Department of Clinical Nutrition and MetabolismWakayama Medical UniversityWakayamaJapan
| | - Hiroyuki Suzuki
- Department of PediatricsWakayama Medical UniversityWakayamaJapan
| | - Takashi Akamizu
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
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36
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Hayakawa K, Nakano R, Hase R, Shimatani M, Kato H, Hasumi J, Doi A, Sekiya N, Nei T, Okinaka K, Kasahara K, Kurai H, Nagashima M, Miyoshi-Akiyama T, Kakuta R, Yano H, Ohmagari N. Comparison between IMP carbapenemase-producing Enterobacteriaceae and non-carbapenemase-producing Enterobacteriaceae: a multicentre prospective study of the clinical and molecular epidemiology of carbapenem-resistant Enterobacteriaceae. J Antimicrob Chemother 2020; 75:697-708. [PMID: 31789374 DOI: 10.1093/jac/dkz501] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/28/2019] [Accepted: 11/05/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Carbapenem-resistant Enterobacteriaceae (CRE) are classified as carbapenemase-producing Enterobacteriaceae (CPE) and non-CPE; the majority of CPE in Japan produce IMP carbapenemase. OBJECTIVES We evaluated the clinico-epidemiological and microbiological information and effects of IMP-type carbapenemase production in CRE. METHODS Patients with isolations of CRE (MICs of meropenem ≥2 mg/L, imipenem ≥2 mg/L or cefmetazole ≥64 mg/L) from August 2016 to March 2018 were included. Microbiological analyses and WGS were conducted and clinical parameters were compared between groups. Independent predictors for the isolation of CPE from patients were identified by logistic regression. For comparing clinical outcomes, a stabilized inverse probability weighting method was used to conduct propensity score-adjusted analysis. RESULTS Ninety isolates (27 CPE and 63 non-CPE) were collected from 88 patients (25 CPE and 63 non-CPE). All CPE tested positive for IMP carbapenemase. Antibiotic resistance (and the presence of resistance genes) was more frequent in the CPE group than in the non-CPE group. Independent predictors for CPE isolation were residence in a nursing home or long-term care facility, longer prior length of hospital stay (LOS), use of a urinary catheter and/or nasogastric tube, dependent functional status and exposure to carbapenem. Although in-hospital and 30 day mortality rates were similar between the two groups, LOS after CRE isolation was longer in the CPE group. CONCLUSIONS IMP-CPE were associated with prolonged hospital stays and had different clinical and microbiological characteristics compared with non-CPE. Tailored approaches are necessary for the investigational and public health reporting, and clinical and infection prevention perspectives for IMP-CPE and non-CPE.
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Affiliation(s)
- Kayoko Hayakawa
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Ryuichi Nakano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan
| | - Ryota Hase
- Department of Infectious Diseases, Japanese Red Cross Narita Hospital, Chiba, Japan
| | - Michitsugu Shimatani
- Department of Infectious Diseases and Infection Control, Hamamatsu Medical Center, Shizuoka, Japan
| | - Hideaki Kato
- Infection Prevention and Control Department, Yokohama City University Hospital, Kanagawa, Japan
| | - Jumpei Hasumi
- Department of Pediatrics, Saku Medical Center, Nagano, Japan
| | - Asako Doi
- Division of Infectious Diseases, Kobe City Medical Center General Hospital, Hyogo, Japan
| | - Noritaka Sekiya
- Department of Infection Prevention and Control, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan
| | - Takahito Nei
- Department of Infection Prevention and Control, Nippon Medical School Hospital, Tokyo, Japan
| | - Keiji Okinaka
- Division of General Internal Medicine, National Cancer Center Hospital East, Chiba, Japan
| | - Kei Kasahara
- Center for Infectious Diseases, Nara Medical University, Nara, Japan
| | - Hanako Kurai
- Division of Infectious Diseases, Shizuoka Cancer Center, Shizuoka, Japan
| | - Maki Nagashima
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tohru Miyoshi-Akiyama
- Pathogenic Microbe Laboratory, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - Risako Kakuta
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan
| | - Hisakazu Yano
- Department of Microbiology and Infectious Diseases, Nara Medical University, Nara, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
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37
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Matsutani N, Furuta H, Matsuno S, Oku Y, Morita S, Uraki S, Doi A, Furuta M, Iwakura H, Ariyasu H, Nishi M, Akamizu T. Identification of a compound heterozygous inactivating ABCC8 gene mutation responsible for young-onset diabetes with exome sequencing. J Diabetes Investig 2020; 11:333-336. [PMID: 31479591 PMCID: PMC7078087 DOI: 10.1111/jdi.13138] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 08/28/2019] [Accepted: 08/29/2019] [Indexed: 11/29/2022] Open
Abstract
Activating mutations in the ABCC8 gene cause diabetes and inactivating mutations usually cause hyperinsulinemic hypoglycemia in infancy. Patients with hypoglycemia in infancy due to a heterozygous inactivating mutation have been reported to occasionally progress to diabetes later in life. We explored the gene responsible for diabetes in two brothers, who were suspected to have diabetes at 15 and 18 years-of-age, respectively, with whole exome sequencing, and identified a compound heterozygous ABCC8 gene mutation (p.Arg168Cys and p.Arg1421Cys). Although their father and mother were heterozygous carriers of the p.Arg168Cys and the p.Arg1421Cys mutation, respectively, neither parent had diabetes. These mutations have been reported to be responsible for hypoglycemia in infancy and function as an inactivating mutation. Our results suggest that the inactivating ABCC8 gene mutation is also important in the etiology of diabetes.
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Affiliation(s)
- Norihiko Matsutani
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Hiroto Furuta
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Shohei Matsuno
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | | | - Shuhei Morita
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Shinsuke Uraki
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Asako Doi
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Machi Furuta
- Clinical Laboratory MedicineWakayama Medical UniversityWakayamaJapan
| | - Hiroshi Iwakura
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Hiroyuki Ariyasu
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
| | - Masahiro Nishi
- Department of Clinical Nutrition and MetabolismWakayama Medical UniversityWakayamaJapan
| | - Takashi Akamizu
- First Department of Internal MedicineWakayama Medical UniversityWakayamaJapan
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38
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Iwata K, Doi A, Oba Y, Matsuo H, Ebisawa K, Nagata M, Nishimura S, Yoshimura K, Masuda A, Shiomi H, Kodama Y. Shortening antibiotic duration in the treatment of acute cholangitis: rationale and study protocol for an open-label randomized controlled trial. Trials 2020; 21:97. [PMID: 31952554 PMCID: PMC6969404 DOI: 10.1186/s13063-020-4046-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 01/02/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Antimicrobial therapy with appropriate biliary drainage is considered the standard of care for acute cholangitis, but the optimal duration of antimicrobial therapy remains unknown. Seven to 10 days of antimicrobial therapy are common for the treatment of acute cholangitis, but a recent retrospective cohort study suggested a shorter duration might be effective. A shorter duration of antimicrobial therapy can be beneficial in decreasing the length of hospital stay, improving patients' quality of life, decreasing adverse effects, and even contributing to a decrease in the occurrence of antimicrobial resistance. METHODS/DESIGN We will conduct a multi-centre, open-label, randomized, non-inferiority trial to compare short-course therapy (SCT) with conventional long-course therapy (LCT) in treating patients with acute cholangitis. SCT consists of 5-day intravenous antimicrobial therapy if the patients had clinical improvement, while at least 7 days of intravenous antibiotics will be provided to the LCT group. The primary outcome is clinical cure at 30 days after onset. Patients will be randomly assigned in an open-label fashion. A total sample size of 150 was estimated to provide a power of 80% with a one-sided α level of 2.5% and a non-inferiority margin of 10%. DISCUSSION This trial is expected to reveal whether SCT is non-inferior to conventional LCT or not, and may provide evidence that one can shorten the treatment duration for acute cholangitis for the benefit of patients. TRIAL REGISTRATION University Hospital Medical Information Network, UMIN000028382. Registered on 30 August 2017.
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Affiliation(s)
- Kentaro Iwata
- Division of Infectious Diseases Therapeutics, Kobe University Graduate School of Medicine, Kusunokicho 7-5-2, Chuoku, Kobe, Hyogo 650-0017 Japan
| | - Asako Doi
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Minatojimaminamimachi, Chuoku, Kobe, Hyogo 650-0047 Japan
| | - Yuichiro Oba
- Department of General Medicine, Osaka General Medical Center, Bandaihigashi 3-1-56, Sumiyoshi, Osaka, 558-8558 Japan
| | - Hiroo Matsuo
- Department of Infectious Diseases, Hyogo Prefectural Amagasaki General Medical Center, Higashinanbacho 2-17-77, Amagasaki, Hyogo 660-8550 Japan
| | - Kei Ebisawa
- Division of Infectious Diseases Therapeutics, Kobe University Graduate School of Medicine, Kusunokicho 7-5-2, Chuoku, Kobe, Hyogo 650-0017 Japan
| | - Manabu Nagata
- Division of Infectious Diseases Therapeutics, Kobe University Graduate School of Medicine, Kusunokicho 7-5-2, Chuoku, Kobe, Hyogo 650-0017 Japan
| | - Sho Nishimura
- Division of Infectious Diseases Therapeutics, Kobe University Graduate School of Medicine, Kusunokicho 7-5-2, Chuoku, Kobe, Hyogo 650-0017 Japan
| | - Kenichi Yoshimura
- Innovative Clinical Research Center (iCREK), Kanazawa University Hospital, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641 Japan
| | - Atsuhiro Masuda
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kusunokicho 7-5-2, Chuoku, Kobe, Hyogo 650-0017 Japan
| | - Hideyuki Shiomi
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kusunokicho 7-5-2, Chuoku, Kobe, Hyogo 650-0017 Japan
| | - Yuzo Kodama
- Department of Gastroenterology, Kobe University Graduate School of Medicine, Kusunokicho 7-5-2, Chuoku, Kobe, Hyogo 650-0017 Japan
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39
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Karatojima M, Furuta H, Matsutani N, Matsuno S, Tamai M, Komiya K, Morita S, Uraki S, Doi A, Furuta M, Iwakura H, Ariyasu H, Nishi M, Akamizu T. A family in which people with a heterozygous ABCC8 gene mutation (p.Lys1385Gln) have progressed from hyperinsulinemic hypoglycemia to hyperglycemia. J Diabetes 2020; 12:21-24. [PMID: 31578783 DOI: 10.1111/1753-0407.12990] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 09/04/2019] [Accepted: 09/23/2019] [Indexed: 12/15/2022] Open
Affiliation(s)
- Mai Karatojima
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiroto Furuta
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Norihiko Matsutani
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Shohei Matsuno
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | | | | | - Shuhei Morita
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Shinsuke Uraki
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Asako Doi
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Machi Furuta
- Clinical Laboratory Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiroshi Iwakura
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Hiroyuki Ariyasu
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
| | - Masahiro Nishi
- Department of Clinical Nutrition and Metabolism, Wakayama Medical University, Wakayama, Japan
| | - Takashi Akamizu
- First Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan
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40
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Hayakawa K, Nakano R, Hase R, Shimatani M, Kato H, Hasumi J, Doi A, Sekiya N, Nei T, Okinaka K, Kasahara K, Kurai H, Nagashima M, Miyoshi-Akiyama T, Kakuta R, Yano H, Ohmagari N. 503. Comparison of IMP Carbapenemase-Producing Enterobacteriaceae (CPE) and Non-Carbapenemase-Producing Enterobacteriaceae: A Multicenter Prospective Study of Clinical and Molecular Epidemiology in Japan. Open Forum Infect Dis 2019. [PMCID: PMC6810466 DOI: 10.1093/ofid/ofz360.572] [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: 11/13/2022] Open
Abstract
Abstract
Background
IMP CPE are the dominant CPE type in Japan. We aimed to compare its epidemiology to that of non-CPE (NCPE).
Methods
Patients with isolation of carbapenem-resistant Enterobacteriaceae (CRE) with meropenem MIC ≥2 mg/L or imipenem MIC ≥2 mg/L and cefmetazole MIC ≥64 mg/L were included from August 2016 to March 2018. Adjusted outcome analyses were conducted using a generalized estimating equation model with weighting based on the inverse probability of propensity scores (PS).
Results
Ninety isolates (27 CPE and 63 NCPE) were collected from 88 patients (53 male) in 7 hospitals. CPE included 10 E. cloacae (ENC), 6 K. pneumoniae (KP), 4 E. coli (EC), 3 C. freundii (CF), 2 K. oxytoca, and 1 each of E. aerogenes (EA) and S. marcescens (SM). NCPE included 34 EA, 15 ENC, 4 each of KP, SM, and 2 CF. All CPE were positive for IMP carbapenemase (11 IMP-11, 6 IMP-42, 4 IMP-6, and 3 each of IMP-10 and IMP-1). Most of CPE/NCPE were isolated from sputum (39%), intra-abdomen (21%), and urine (20%). Levofloxacin, gentamicin, and amikacin resistance were found in 6 (22%), 4 (15%), and 1 (4%) CPE, respectively, and 6 (10%), 6 (10%), and 0 NCPE, respectively. Eighteen (67%) blaIMP were transferable by conjugation. Cases of CPE involved older patients with more frequent use of devices and carbapenem exposure than those in cases of NCPE (table). The mortality was similar in the 2 groups. Length of hospital stay (LOS) after CPE/NCPE isolation was significantly higher in the CPE group after PS adjustment (P = 0.02).
Conclusion
CPE had distinct epidemiological characteristics, and CPE isolation was associated with a prolonged hospital stay. Defining the underlying resistance mechanism of CRE is important for appropriate management.
Disclosures
All authors: No reported disclosures.
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Affiliation(s)
- Kayoko Hayakawa
- National Center for Global Health and Medicine Hospital, Shinjuku, Tokyo, Japan
| | | | - Ryota Hase
- Japanese Red Cross Narita Hospital/Kameda Medical Center, Narita, Chiba, Japan
| | | | - Hideaki Kato
- Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa, Japan
| | | | - Asako Doi
- Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | - Noritaka Sekiya
- Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan
| | - Takahito Nei
- Nippon Medical School Hospital, Bunkyo, Tokyo, Japan
| | - Keiji Okinaka
- National Cancer Center Hospital East, Kashiwa, Chiba, Japan
| | - Kei Kasahara
- Nara Medical University, Kashihara City, Nara, Japan
| | - Hanako Kurai
- Shizuoka Cancer Center, Japan, Nagaizumi, Shizuoka, Japan
| | - Maki Nagashima
- National Center for Global Health and Medicine, Shinjuku, Tokyo, Japan
| | | | - Risako Kakuta
- Nara Medical University, Kashihara City, Nara, Japan
| | - Hisakazu Yano
- Nara Medical University, Kashihara City, Nara, Japan
| | - Norio Ohmagari
- National Center for Global Health and Medicine Hospital, Shinjuku, Tokyo, Japan
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Abstract
A 74-year-old Japanese man who was taking antacids presented with profuse diarrhea. Stool culture revealed Vibrio cholerae O1 strain, serogroup Ogawa, biotype El tor. He recalled he had consumed some sashimi but denied any history of travelling abroad, and another cholera case with almost the same strain was reported at the same time in a remote prefecture in the Kanto area. This is a rare case of travel-unrelated cholera in Japan, and it illustrates the importance of suspecting cholera in all patients presenting with large volumes of watery diarrhea in Japan, especially in those who are taking antacids, regardless of their international travel history.
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Affiliation(s)
- Masao Tatebe
- Department of Emergency, Kobe City Medical Center General Hospital, Japan
| | - Asako Doi
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Japan
| | - Seiko Nasu
- Department of Laboratory Medicine, Kobe City Medical Center General Hospital, Japan
| | | | | | - Eiji Arakawa
- National Institute of Infectious Diseases, Japan
| | | | - Hiroaki Nishioka
- Department of Infectious Diseases, Kobe City Medical Center General Hospital, Japan
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42
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Matsuno S, Furuta H, Kosaka K, Doi A, Yorifuji T, Fukuda T, Senmaru T, Uraki S, Matsutani N, Furuta M, Mishima H, Iwakura H, Nishi M, Yoshiura K, Fukui M, Akamizu T. Identification of a variant associated with early-onset diabetes in the intron of the insulin gene with exome sequencing. J Diabetes Investig 2019; 10:947-950. [PMID: 30414308 PMCID: PMC6626945 DOI: 10.1111/jdi.12974] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/28/2018] [Accepted: 11/04/2018] [Indexed: 11/30/2022] Open
Abstract
Whole-exome sequencing is a new technology. We used it to explore the gene responsible for early-onset diabetes as a result of impaired insulin secretion in a family. In the INS gene, we identified the heterozygous c.188-31G>A mutation in the proband - a 43-year-old woman. The mutation was also identified in her two daughters with diabetes, but not in her son or her parents, all of whom did not have diabetes. The substitution was located 31 bp proximal to exon 3 in intron 2. It was predicted to create an ectopic splice site leading to inserting 29 nucleotides of intron 2 as an exonic sequence in the transcript. The mutation has been reported in White families, and the present case is the first report in an Asian person. The present results would help in understanding the role of the mutation in developing diabetes.
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Affiliation(s)
- Shohei Matsuno
- The First Department of MedicineWakayama Medical UniversityWakayamaJapan
| | - Hiroto Furuta
- The First Department of MedicineWakayama Medical UniversityWakayamaJapan
| | - Kitaro Kosaka
- Department of PediatricsKyoto Prefectural University of MedicineKyotoJapan
| | - Asako Doi
- The First Department of MedicineWakayama Medical UniversityWakayamaJapan
| | - Tohru Yorifuji
- Division of Pediatric Endocrinology and Metabolism, Children's Medical CenterOsaka City General HospitalOsakaJapan
| | - Takuya Fukuda
- Department of Endocrinology and MetabolismKyoto Prefectural University of MedicineKyotoJapan
| | - Takafumi Senmaru
- Department of Endocrinology and MetabolismKyoto Prefectural University of MedicineKyotoJapan
| | - Shinsuke Uraki
- The First Department of MedicineWakayama Medical UniversityWakayamaJapan
| | - Norihiko Matsutani
- The First Department of MedicineWakayama Medical UniversityWakayamaJapan
| | - Machi Furuta
- Clinical Laboratory MedicineWakayama Medical UniversityWakayamaJapan
| | - Hiroyuki Mishima
- Department of Human GeneticsNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Hiroshi Iwakura
- The First Department of MedicineWakayama Medical UniversityWakayamaJapan
| | - Masahiro Nishi
- Department of Clinical Nutrition and MetabolismWakayama Medical UniversityWakayamaJapan
| | - Kohichiro Yoshiura
- Department of Human GeneticsNagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Michiaki Fukui
- Department of Endocrinology and MetabolismKyoto Prefectural University of MedicineKyotoJapan
| | - Takashi Akamizu
- The First Department of MedicineWakayama Medical UniversityWakayamaJapan
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43
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Tanioka H, Nagasaka T, Uno F, Inoue M, Okita H, Katata Y, Kanzaki H, Kuramochi H, Satake H, Shindo Y, Doi A, Nasu J, Yamashita H, Yamaguchi Y. Relationship between peripheral neuropathy and effectiveness in second-line chemotherapy for unresectable advanced gastric cancer: a prospective, observational, multicenter study protocol. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz155.113] [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: 11/14/2022] Open
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44
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Doi A, Kano S, Asano M, Takahashi Y, Mimori T, Mimori A, Kaneko H. Autoantibodies to killer cell immunoglobulin-like receptor 3DL1 in patients with systemic lupus erythematosus. Clin Exp Immunol 2018; 195:358-363. [PMID: 30421793 DOI: 10.1111/cei.13235] [Citation(s) in RCA: 2] [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] [Accepted: 11/05/2018] [Indexed: 10/27/2022] Open
Abstract
A genetic variant of the killer immunoglobulin-like receptor 3DL1 (KIR3DL1) has been found in patients with systemic lupus erythematosus (SLE). Herein, we investigated the presence of autoantibodies to KIR3DL1 in a cohort of patients with SLE. We tested sera from 28 patients with SLE, 11 patients with rheumatoid arthritis (RA) and 17 healthy control subjects for anti-KIR3DL1 activity by an enzyme-linked immunosorbent assay (ELISA) using recombinant KIR3DL1-enhanced green fluorescent protein (EGFP) and EGFP proteins. Anti-KIR3DL1 antibodies were detected in 22 (79%) of the 28 patients with SLE, whereas they were present in only three (27%) of the 11 patients with RA examined. Notably, 10 (91%) of the 11 samples from patients with SLE prior to therapy had anti-KIR3DL1 antibodies. None of the samples from healthy donors were positive for the antibodies. Here, we report the presence of anti-KIR3DL1 antibodies in the sera of patients with SLE for the first time. Anti-KIR3DL1 autoantibodies may be involved in the pathogenesis of autoimmune diseases.
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Affiliation(s)
- A Doi
- Department of Intractable Diseases, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan.,Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
| | - S Kano
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan.,Department of Tropical Medicine and Malaria, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan
| | - M Asano
- Division of Rheumatic Diseases, Hospital, National Center for Global Health and Medicine, Tokyo, Japan.,Graduate School of Medical Science, Nagoya City University, Nagoya, Japan
| | - Y Takahashi
- Division of Rheumatic Diseases, Hospital, National Center for Global Health and Medicine, Tokyo, Japan
| | - T Mimori
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - A Mimori
- Division of Rheumatic Diseases, Hospital, National Center for Global Health and Medicine, Tokyo, Japan
| | - H Kaneko
- Division of Rheumatic Diseases, Hospital, National Center for Global Health and Medicine, Tokyo, Japan
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45
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Ueno M, Doi A, Mouri H, Mizuno M. How can we predict the possibility of advanced gastric cancer patients to receive third-line chemotherapy in the real-world setting? Ann Oncol 2018. [DOI: 10.1093/annonc/mdy432.025] [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: 11/12/2022] Open
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46
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Nakamura M, Yagisawa M, Saiki T, Ishiguro A, Sawada K, Yuki S, Sasaki T, Ando T, Ohori H, Kotaka M, Muto O, Shindo Y, Nakashima K, Hosokawa A, Doi A, Izawa N, Sunakawa Y, Satoh A, Ono K, Komatsu Y. A feasibility study of edoxaban for the cancer-associated asymptomatic venous thromboembolism in Japanese gastrointestinal cancer patients receiving chemotherapy (ExCAVE study). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy444.032] [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: 11/14/2022] Open
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47
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Mizukami T, Sunakawa Y, Arai H, Chosokabe M, Doi A, Horie Y, Hirakawa M, Saji O, Naruki S, Izawa N, Ogura T, Tsuda T, Enomoto T, Mikami S, Fujino T, Otsubo T, Nakajima T. Dynamic change of immune-related gene expression status during chemoradiotherapy in locally advanced esophageal cancer. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy303.024] [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: 11/13/2022] Open
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48
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Tomiyasu H, Doi A, Chambers JK, Goto-Koshino Y, Ohmi A, Ohno K, Tsujimoto H. Clinical and clinicopathological characteristics of acute lymphoblastic leukaemia in six cats. J Small Anim Pract 2018; 59:742-746. [DOI: 10.1111/jsap.12917] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 05/21/2018] [Accepted: 07/21/2018] [Indexed: 12/31/2022]
Affiliation(s)
- H. Tomiyasu
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences; The University of Tokyo; 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657 Japan
| | - A. Doi
- Veterinary Medical Center, Graduate School of Agricultural and Life Sciences; The University of Tokyo; 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657 Japan
| | - J. K. Chambers
- Department of Veterinary Pathology, Graduate School of Agricultural and Life Sciences; The University of Tokyo; 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657 Japan
| | - Y. Goto-Koshino
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences; The University of Tokyo; 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657 Japan
| | - A. Ohmi
- Veterinary Medical Center, Graduate School of Agricultural and Life Sciences; The University of Tokyo; 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657 Japan
| | - K. Ohno
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences; The University of Tokyo; 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657 Japan
| | - H. Tsujimoto
- Department of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences; The University of Tokyo; 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657 Japan
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49
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Iwata K, Doi A, Higasa S. Current status and future prospects of AIDS core hospitals in Japan. Int J Infect Dis 2018. [DOI: 10.1016/j.ijid.2018.04.3968] [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: 10/28/2022] Open
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50
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Takase M, Shirai M, Matsushita H, Umehara H, Wakabayashi S, Doi A, Inoue I. The severity of unilateral spatial neglect was positively correlated with that of Pusher syndrome. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.078] [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: 10/28/2022]
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