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Ueda T, Fujitsuna R, Saito H, Nakazawa K, Hayashi H, Kumita SI. Kinking of the Aortic Body Contralateral Leg due to Twisting Force in an Alto Endograft. J Vasc Interv Radiol 2024:S1051-0443(24)00271-9. [PMID: 38589010 DOI: 10.1016/j.jvir.2024.03.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/19/2024] [Accepted: 03/30/2024] [Indexed: 04/10/2024] Open
Affiliation(s)
- Tatsuo Ueda
- Department of Radiology, Nippon Medical School Hospital, Tokyo, Japan.
| | - Ryutaro Fujitsuna
- Department of Radiology, Nippon Medical School Hospital, Tokyo, Japan
| | - Hidemasa Saito
- Department of Radiology, Nippon Medical School Hospital, Tokyo, Japan
| | - Ken Nakazawa
- Department of Radiology, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Hiromitsu Hayashi
- Department of Radiology, Nippon Medical School Hospital, Tokyo, Japan
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2
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Takemoto H, Kado A, Kitani H, Katsuura C, Mizuno S, Saito H, Makari Y. Examination Of The Influence Of Polypharmacy On Nutritional Management Of Inpatients From The Results Of The Survey On Nutritionday. Clin Nutr ESPEN 2023. [DOI: 10.1016/j.clnesp.2022.09.186] [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: 03/28/2023]
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3
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Reinmuth N, Cho B, Luft A, Alexander JA, Geater SL, Laktionov K, Kim SW, Ursol G, Hussein M, Lim F, Yang CT, Araujo L, Saito H, Barrett K, Lowery C, Tattersfield R, Peters S, Garon E, Mok T, Johnson M. 12MO Patterns of response in metastatic (m) NSCLC after 2 and 4 cycles of chemotherapy (CT), alone or with durvalumab (D) ± tremelimumab (T), in the phase III POSEIDON study. J Thorac Oncol 2023. [DOI: 10.1016/s1556-0864(23)00266-6] [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: 04/04/2023]
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4
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Saito H, Sugihara F, Ueda T, Hayashi H, Shirai S, Matsumoto T, Fujitsuna R, Kumita SI. Efficacy of endovascular treatment for completely occlusive acute-subacute portal and mesenteric vein thrombosis with severe complications in patients without cirrhosis. Jpn J Radiol 2023; 41:541-550. [PMID: 36680703 PMCID: PMC10147747 DOI: 10.1007/s11604-022-01377-9] [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: 09/02/2022] [Accepted: 12/16/2022] [Indexed: 01/22/2023]
Abstract
PURPOSE Completely occlusive acute-subacute portal and mesenteric vein thrombosis (PVMVT) with severe complications is fatal. Endovascular treatments (EVTs) of acute-subacute PVMVT are not standardized. Thrombectomy combined with continuous catheter-directed thrombolysis is considered an effective treatment. Here, we aimed to evaluate the outcome of EVTs of completely occlusive acute-subacute PVMVT with severe complications in patients without cirrhosis. MATERIALS AND METHODS Nineteen patients (nine men and 10 women; age, 60.1 ± 16.8 years) with completely occlusive acute-subacute PVMVT were retrospectively assessed. Acute-subacute PVMVT was defined as symptom onset within 40 days, with no cavernous transformation observed on contrast-enhanced computed tomography. The patients were treated with EVTs, a combination of thrombectomy (including aspiration thrombectomy, plain old balloon angioplasty, single injection of thrombolytic agents, and stent placement) and continuous catheter-directed thrombolysis. Kaplan-Meier analyses were performed to assess all-cause mortality, acute-subacute PVMVT-related mortality, and portal vein (PV) patency. The degree of recanalization and patency of PV, complications, factors related to acute-subacute PVMVT-related mortality, and factors related to patency of PV were also evaluated. RESULTS The all-cause and acute-subacute PVMVT-related mortality rates were 36.8% (7/19) and 31.6% (6/19), respectively. Seven (36.8%) and 11 (57.9%) patients achieved complete and partial recanalization, respectively. Among the 18 patients who achieved recanalization, follow-up images after 608.7 ± 889.5 days confirmed recanalization in 83.3% (15/18) patients, and 53.3% (8/15) of these patients achieved patency of PV. Seven patients (36.8%) developed complications, and two (10.5%) required interventional treatment for complications. Deterioration of liver function significantly worsened the prognosis (P = 0.046), while anticoagulation therapy significantly maintained portal patency (P = 0.03). CONCLUSION This endovascular method for acute-subacute PVMVT, which combines thrombectomy and continuous catheter-directed thrombolysis EVT approach was effective for thrombus resolution. However, further studies must define conditions that improve patient prognosis.
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Affiliation(s)
- Hidemasa Saito
- Department of Radiology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
| | - Fumie Sugihara
- Department of Radiology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Tatsuo Ueda
- Department of Radiology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Hiromitsu Hayashi
- Department of Radiology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Sayaka Shirai
- Department of Radiology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Taiga Matsumoto
- Department of Radiology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Ryutaro Fujitsuna
- Department of Radiology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Shin-Ichiro Kumita
- Department of Radiology, Nippon Medical School, 1-1-5, Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
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5
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Okada T, Akutsu K, Saito H, Nakata J, Yamamoto T. Imaging Study of Acute Limited Intimal Tear. Circ Rep 2023; 5:13-14. [PMID: 36643093 PMCID: PMC9815956 DOI: 10.1253/circrep.cr-22-0097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/22/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Taiji Okada
- Department of Cardiovascular Medicine, Nippon Medical SchoolTokyoJapan
| | - Koichi Akutsu
- Department of Cardiovascular Medicine, Nippon Medical SchoolTokyoJapan
| | - Hidemasa Saito
- Department of Radiology, Nippon Medical SchoolTokyoJapan
| | - Jun Nakata
- Division of Cardiovascular Intensive Care, Nippon Medical SchoolTokyoJapan
| | - Takeshi Yamamoto
- Division of Cardiovascular Intensive Care, Nippon Medical SchoolTokyoJapan
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6
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Cho B, Luft A, Alatorre Alexander J, Lucien Geater S, Laktionov K, Sang-We K, Ursol G, Hussein M, Lim Farah L, Yang C, Araujo L, Saito H, Reinmuth N, Lai Z, Mann H, Shi X, Peters S, Garon E, Mok T, Johnson M. 326P Durvalumab (D) ± tremelimumab (T) + chemotherapy (CT) in 1L metastatic (m) NSCLC: Overall survival (OS) update from POSEIDON after median follow-up (mFU) of approximately 4 years (y). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.365] [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: 12/07/2022] Open
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7
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Nakamura A, Kagaya Y, Saito H, Kanazawa M, Sato K, Miura M, Kondo M, Endo H. Efficacy and safety of pemafibrate versus bezafibrate in coronary artery disease patients receiving statin treatment: a randomized, open-label, cross-over study. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2665] [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
Fibrates activate peroxisome proliferator-activated receptor (PPAR)-α which is associated with lipid metabolism. Bezafibrate is a non-selective PPAR-α agonist, whereas pemafibrate has been developed as a higher selective PPAR-α agonist.
Objective
The efficacy and safety of pemafibrate for 24-week in patients with dyslipidemia was examined in comparison with bezafibrate.
Methods
Sixty patients with hypertriglyceridemia (fasting triglyceride (TG) level of ≥150 mg/dL) were treated with pemafibrate of 0.2 mg/day or bezafibrate of 400 mg/day for 24-week in a randomized cross-over study. Percent change from baseline in TG levels was the primary endpoint, and that in HDL-C and apolipoprotein A-I (Apo A-I) levels was the secondary endpoints.
Results
A significantly greater reduction in TG percent change was observed in pemafibrate than in bezafibrate (−46.1% vs. −34.7%, p<0.001). There was no significant difference in HDL-C percent change between pemafibrate and bezafibrate (18.4% vs. 14.0%, p=0.067), whereas Apo A-I percent change was significantly greater in pemafibrate than in bezafibrate (9.2% vs. 5.7%, p=0.018). Pemafibrate and bezafibrate significantly decreased alanine aminotransferase (ALT) and gamma-glutamyltransferase (γ-GT) levels, and pemafibrate showed a greater reduction than bezafibrate (ALT: −21.9% vs. −10.6%, p=0.048; γ-GT: −43.5% vs. −33.1%, p=0.025). Creatinine levels significantly increased in both treatments (both p<0.001), however, creatinine percent change was significantly smaller in pemafibrate than in bezafibrate (5.72% vs. 15.5%, p<0.001). There was no difference in frequency of adverse event (AE) or serious AE between two treatments, but frequency of creatinine elevation (≥0.5 mg/d and/or 25%) was significantly higher in bezafibrate than in pemafibrate (16/60 vs. 3/60, p=0.004).
Conclusion
As compared with bezafibrate, pemafibrate is more effective to reduce TG levels and to elevate Apo A-I levels, and it is safer in terms of liver and renal function.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- A Nakamura
- Iwate Prefectural Central Hospital , Morioka , Japan
| | - Y Kagaya
- Iwate Prefectural Central Hospital , Morioka , Japan
| | - H Saito
- Iwate Prefectural Central Hospital , Morioka , Japan
| | - M Kanazawa
- Iwate Prefectural Central Hospital , Morioka , Japan
| | - K Sato
- Iwate Prefectural Central Hospital , Morioka , Japan
| | - M Miura
- Iwate Prefectural Central Hospital , Morioka , Japan
| | - M Kondo
- Iwate Prefectural Central Hospital , Morioka , Japan
| | - H Endo
- Iwate Prefectural Central Hospital , Morioka , Japan
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8
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Shinada K, Murakami S, Katakura S, Usio R, Kondo T, Kato T, Yokose T, Kasajima R, Miyagi Y, Saito H. EP11.01-008 Discrepancy in MET Exon 14 Skipping Mutation Measurement Between ArcherMET and Oncomine Dx Target Test System. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.905] [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: 10/14/2022]
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9
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Garon E, Cho B, Luft A, Alatorre-Alexander J, Geater S, Kim SW, Ursol G, Hussein M, Lim F, Yang CT, Araujo L, Saito H, Reinmuth N, Kohlmann M, Shi X, Mann H, Peters S, Mok T, Johnson M. EP08.01-027 Durvalumab (D) ± Tremelimumab (T) + Chemotherapy (CT) in 1L Metastatic NSCLC: Outcomes by Tumour PD-L1 Expression in POSEIDON. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.599] [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: 10/14/2022]
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Peters S, Cho B, Luft A, Alatorre-Alexander J, Geater S, Kim SW, Ursol G, Hussein M, Lim F, Yang CT, Araujo L, Saito H, Reinmuth N, Stewart R, Lai Z, Doake R, Krug L, Garon E, Mok T, Johnson M. OA15.04 Association Between KRAS/STK11/KEAP1 Mutations and Outcomes in POSEIDON: Durvalumab ± Tremelimumab + Chemotherapy in mNSCLC. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Yoh K, Kenmotsu H, Yamamoto N, Misumi T, Takahashi T, Saito H, Sugawara S, Yamazaki K, Nakagawa K, Sugio K, Seto T, Toyooka S, Date H, Mitsudomi T, Okamoto I, Yokoi K, Saka H, Okamoto H, Takiguchi Y, Tsuboi M. 931MO Final overall survival analysis of phase III study of pemetrexed/cisplatin versus vinorelbine/cisplatin for completely resected non-squamous non-small cell lung cancer: The JIPANG Study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1057] [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: 11/17/2022] Open
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Yanagisawa-Sugita A, Iba A, Maeda E, Jwa SC, Saito K, Kuwahara A, Saito H, Terada Y, Ishihara O, Kobayashi Y. O-080 Impact of age-limit policy change for assisted reproductive technology (ART) subsidy in Japan. Hum Reprod 2022. [DOI: 10.1093/humrep/deac104.094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What was the impact on treatment age in Japan after a subsidy policy change that set age limits for assisted reproductive technology (ART) treatment?
Summary answer
The national policy introducing age limits in the subsidy may have promoted ART treatment among younger women.
What is known already
Japan has provided partial subsidies for ART treatment since 2004. To promote treatment at a younger age, the government introduced a subsidy policy in 2016 that set age limits: up to six treatment cycles for women younger than 40 years of age; and up to three cycles for women between 40 and 42 years old. However, two out of 47 prefectures continued to provide subsidies to women aged 43 and older.
Study design, size, duration
We conducted a time series analysis of the utilisation of ART before and after the introduction of age limits, using data from the Japanese national ART registry from 2012 to 2016.
Participants/materials, setting, methods
We described the number of fresh and frozen treatment cycles, comparing the number between 45 prefectures that followed the national policy change (hereafter, prefectures with age limits) and two prefectures that did not (hereafter, prefectures without age limits). Ordinary least squares regression models were used to assess the impact of the policy change by prefecture on the number of ART cycles by women of different ages.
Main results and the role of chance
The overall number of fresh and frozen ART cycles continuously increased in all age groups from 2012 to 2016. Meanwhile, the number of fresh ART cycles among women aged ≤ 36 and 37-39 years in 2016 increased from the previous year by + 4.0% and +1.8% in prefectures with age limits, whereas it decreased in prefectures without age limits: -3.1% and -2.3%, respectively. The number of fresh ART cycles among women aged 40-42 and 43-45 years in prefectures with age limits in 2016 changed by + 1.5% and -0.1%, respectively, whereas it increased considerably in prefectures without age limits by + 9.6% and +65.4%, respectively. Similar changes were shown for the frozen cycles. After controlling for underlying time trends and prefectural characteristics, the policy change significantly increased the number of fresh and frozen ART treatment cycles among women aged ≤ 36 years and decreased the treatment cycles of women aged 40-42 years.
Limitations, reasons for caution
We evaluated the change observed in the year of the policy change and could not assess longer-term trends. Additionally, unobserved factors might have contributed to the change in treatment numbers.
Wider implications of the findings
The introduction of a policy to set an age limit for the partial ART subsidy resulted in a significant increase in treatment even among age groups younger than the boundary groups. The policy change might have conveyed educational messages regarding the benefits of early treatment.
Trial registration number
not applicable
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Affiliation(s)
| | - A Iba
- The University of Tokyo, Public Health, Tokyo , Japan
| | - E Maeda
- Akita University Graduate School of Medicine, Environmental Health Science and Public Health, Akita , Japan
| | - S C Jwa
- Saitama Medical University, Obstetrics and Gynecology, Saitama , Japan
| | - K Saito
- Tokyo Medical and Dental University, Comprehensive Reproductive Medicine, Tokyo , Japan
| | - A Kuwahara
- Tokushima University, Obstetrics and Gynecology, Tokushima , Japan
| | - H Saito
- Umegaoka Women's Clinic, ART center, Tokyo , Japan
| | - Y Terada
- Akita University Graduate School of Medicine, Obstetrics and Gynecology, Akita , Japan
| | - O Ishihara
- Saitama Medical University, Obstetrics and Gynecology, Saitama , Japan
| | - Y Kobayashi
- The University of Tokyo, Public Health, Tokyo , Japan
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Funaki T, Kanazawa M, Takahashi S, Seki T, Iguchi A, Kagaya Y, Sato K, Saito H, Kondo M, Miura M, Kawatsu S, Endo H, Oda K, Nakamura A. The orthostatic hypotension in patients with Stanford type A aortic dissection after surgery. Eur J Prev Cardiol 2022. [DOI: 10.1093/eurjpc/zwac056.070] [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]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Orthostatic hypotension (OH) is sometimes observed during cardiac rehabilitation in patients with surgery for aortic dissection. However, little is known about the primary determinant of OH and influence of surgical range on incidence of OH.
Purpose
The aim of this study was to elucidate the incidence of OH in patients with surgery for aortic dissection, and compare it between the patients with ascending aortic replacement surgery (ascending group) and those with ascending aorta and hemiarch or total arch replacement surgery (arch group).
Methods
We analyzed 59 patients who underwent emergent surgery due to Stanford type A aortic dissection from January 2014 to March 2018, and compared the incidence of OH between ascending group (n = 28, age 69.8 ± 11.3 years) and arch group (n = 31, age 64.1 ± 13.0 years).
Results
The incidence of OH in total patients was 30.5%. There were no significant differences in patient characteristics including body tall, body weight, antihypertensive use and progress of rehabilitation between 2 groups. The arch group showed a significant higher incidence of OH as compared with ascending group (arch group: 46.4% vs. ascending group: 16.1%, p = 0.03). Moreover, the patients who occurred OH were significantly taller than those who did not occur OH.
Conclusions
OH was observed in about one third of patients with surgery for aortic dissection and it showed a close relationship with patient’s height and the range repaired by surgical operation. More careful cardiac rehabilitation is needed for tall patients with large area replacement of aorta.
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Affiliation(s)
- T Funaki
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - M Kanazawa
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - S Takahashi
- Iwate Prefectural Central Hospital, Department of Rehabilitation, Morioka, Japan
| | - T Seki
- Iwate Prefectural Central Hospital, Department of Rehabilitation, Morioka, Japan
| | - A Iguchi
- Iwate Prefectural Central Hospital, Department of Rehabilitation, Morioka, Japan
| | - Y Kagaya
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - K Sato
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - H Saito
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - M Kondo
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - M Miura
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - S Kawatsu
- Iwate Prefectural Central Hospital, Department of Cardiovascular surgery, Morioka, Japan
| | - H Endo
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - K Oda
- Iwate Prefectural Central Hospital, Department of Cardiovascular surgery, Morioka, Japan
| | - A Nakamura
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
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Garon E, Cho B, Luft A, Alatorre-Alexander J, Geater S, Trukhin D, Kim SW, Ursol G, Hussein M, Lim F, Yang CT, Araujo L, Saito H, Reinmuth N, Medic N, Mann H, Shi X, Peters S, Mok T, Johnson M. 5MO Patient reported outcomes (PROs) with 1L durvalumab (D), with or without tremelimumab (T), plus chemotherapy (CT) in metastatic (m) NSCLC: Results from POSEIDON. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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15
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Shirai S, Ueda T, Sugihara F, Yasui D, Saito H, Furuki H, Kim S, Yoshida H, Yokobori S, Hayashi H, Kumita SI. Transileocolic endovascular treatment by a hybrid approach for severe acute portal vein thrombosis with bowel necrosis: Two case reports. World J Clin Cases 2022; 10:1876-1882. [PMID: 35317162 PMCID: PMC8891780 DOI: 10.12998/wjcc.v10.i6.1876] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/22/2021] [Accepted: 01/20/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Acute portal vein thrombosis (PVT) with bowel necrosis is a fatal condition with a 50%-75% mortality rate. This report describes the successful endovascular treatment (EVT) of two patients with severe PVT.
CASE SUMMARY The first patient was a 22-year-old man who presented with abdominal pain lasting 3 d. The second patient was a 48-year-old man who presented with acute abdominal pain. Following contrast-enhanced computed tomography, both patients were diagnosed with massive PVT extending to the splenic and superior mesenteric veins. Hybrid treatment (simultaneous necrotic bowel resection and EVT) was performed in a hybrid operating room (OR). EVTs, including aspiration thrombectomy, catheter-directed thrombolysis (CDT), and continuous CDT, were performed via the ileocolic vein under laparotomy. The portal veins were patent 4 and 6 mo posttreatment in the 22-year-old and 48-year-old patients, respectively.
CONCLUSION Hybrid necrotic bowel resection and transileocolic EVT performed in a hybrid OR is effective and safe.
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Affiliation(s)
- Sayaka Shirai
- Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku 113-8603, Tokyo, Japan
| | - Tatsuo Ueda
- Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku 113-8603, Tokyo, Japan
| | - Fumie Sugihara
- Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku 113-8603, Tokyo, Japan
| | - Daisuke Yasui
- Department of Radiology, Nippon Medical School Musashi Kosugi Hospital, Kawasaki-shi 211-8533, Kanagawa, Japan
| | - Hidemasa Saito
- Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku 113-8603, Tokyo, Japan
| | - Hiroyasu Furuki
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Tamanagayama Hospital, Tama-shi 206-8512, Tokyo, Japan
| | - Shiei Kim
- Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital, Bunkyo-ku 113-8603, Tokyo, Japan
| | - Hiroshi Yoshida
- Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Bunkyo-ku 113-8603, Tokyo, Japan
| | - Shoji Yokobori
- Department of Emergency and Critical Care Medicine, Nippon Medical School Hospital, Bunkyo-ku 113-8603, Tokyo, Japan
| | - Hiromitsu Hayashi
- Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku 113-8603, Tokyo, Japan
| | - Shin-ichiro Kumita
- Department of Radiology, Nippon Medical School Hospital, Bunkyo-ku 113-8603, Tokyo, Japan
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16
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Saito H, Murata S, Sugihara F, Ueda T, Yasui D, Miki I, Hayashi H, Kumita SI. Successful embolization of an intrahepatic portosystemic shunt using balloon-occluded retrograde transvenous obliteration: A case report. World J Clin Cases 2022; 10:2023-2029. [PMID: 35317161 PMCID: PMC8891793 DOI: 10.12998/wjcc.v10.i6.2023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 11/16/2021] [Accepted: 01/14/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND A congenital intrahepatic portosystemic shunt (IPSVS) is a rare vascular abnormality that is characterized by an anomalous intrahepatic venous tract that connects the intrahepatic portal vein with the hepatic venous system. Hepatic encephalopathy is an indication for IPSVS embolization, which is technically challenging because rapid blood flow through shunts can induce the migration of embolization material to systemic veins. This case report discusses the efficacy of percutaneous balloon-occluded retrograde transvenous obliteration for treating patients with IPSVSs.
CASE SUMMARY A 75-year-old woman presented with a six-month history of repeated hepatic encephalopathy due to an IPSVS without liver cirrhosis. We successfully embolized the IPSVS using percutaneous balloon-occluded retrograde transvenous obliteration with interlocking detachable coils. After the procedure, the patient exhibited no symptoms of hepatic encephalopathy for 14 mo.
CONCLUSION Balloon-occluded retrograde transvenous obliteration with detachable coils can be effective for the endovascular treatment of an IPSVS.
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Affiliation(s)
- Hidemasa Saito
- Department of Radiology, Nippon Medical School, Tokyo 113-8602, Japan
| | - Satoru Murata
- Center for Interventional Radiology, Teikyo University Chiba Medical Center, Chiba 299-0011, Japan
| | - Fumie Sugihara
- Department of Radiology, Nippon Medical School, Tokyo 113-8602, Japan
| | - Tatsuo Ueda
- Department of Radiology, Nippon Medical School, Tokyo 113-8602, Japan
| | - Daisuke Yasui
- Department of Radiology, Nippon Medical School, Tokyo 113-8602, Japan
| | - Izumi Miki
- Department of Radiology, Nippon Medical School, Tokyo 113-8602, Japan
| | - Hiromitsu Hayashi
- Department of Radiology, Nippon Medical School, Tokyo 113-8602, Japan
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Oates TW, Guy V, Ni K, Ji C, Saito H, Shiau H, Shah R, Williams MA, Blasi G, Goloubeva O. Meta-regression Analysis of Study Heterogeneity for Systemic Outcomes after Periodontal Therapy. JDR Clin Trans Res 2022; 8:23800844211070467. [PMID: 35037489 DOI: 10.1177/23800844211070467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION The contribution of periodontal disease to adverse systemic consequences remains controversial. This analysis examined 2 well-investigated conditions independently and combined-adverse pregnancy outcomes and glycemic control for patients with diabetes-based on shared pathogenic mechanisms of periodontal infection and inflammation. It was proposed that inconsistencies in study design significantly contribute to outcome discrepancies found between periodontal intervention studies undergoing meta-analysis. METHODS Meta-analyses evaluating periodontal interventions on the rate of preterm birth and changes in glycated hemoglobin A1c in type 2 diabetes populations were conducted based on a systematic review of randomized controlled trials. Meta-regression covariates for exploring heterogeneity included sample size, level of medical management, and bias risk as moderator variables in a random-effects meta-regression. RESULTS Systematic review identified 17 studies of diabetes and 13 of pregnancy outcomes. Analyses of these studies identified 0.50% reduction in HbA1c and 0.78 odds ratio for preterm births. The heterogeneity associated with the models was high (I2 = 92.4 and I2 = 62.7%, respectively). The adjusted models evaluating each systemic condition separately accounted for 52.2% of the effect for diabetes and 81.4% for pregnancy outcome effects independently, and 63.5% collectively, across interventional studies. CONCLUSION This systematic review with meta-regression analysis of heterogeneity demonstrates that disparate results seen in randomized controlled trials of periodontal therapy affecting systemic outcomes may be explained in large part by study design, specifically stringency in consideration of medical management and sample size. The potential for confounding factors to influence outcomes remains a concern in understanding the implications of oral health on systemic conditions. KNOWLEDGE TRANSFER STATEMENT The findings of this study demonstrate that much of the benefits seen from periodontal therapy on adverse systemic outcomes for diabetes and pregnancy are due to limitations in study design.
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Affiliation(s)
- T W Oates
- Division of Periodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - V Guy
- Division of Periodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, USA
- Current affiliation: Private practice, Summerville, SC, USA
| | - K Ni
- Division of Periodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, USA
- Current affiliation: Private practice, Lancaster, PA, USA
| | - C Ji
- Division of Periodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, USA
- Current affiliation: Division of Periodontology and Implant Dentistry, Faculty of Dentistry, University of Hong Kong, Hong Kong
| | - H Saito
- Division of Periodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - H Shiau
- Division of Periodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, USA
| | - R Shah
- University of Maryland School of Dentistry, Baltimore, MD, USA
- Current affiliation: UCSF School of Dentistry, University of California, San Francisco, San Francisco, CA, USA
| | - M A Williams
- Health Sciences & Human Services Library, University of Maryland, Baltimore, MD, USA
| | - G Blasi
- Division of Periodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, USA
- Current affiliation: Private practice, Barcelona, Spain
| | - O Goloubeva
- Division of Periodontics, Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD, USA
- Department of Epidemiology & Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
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18
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Ueda T, Murata S, Tajima H, Saito H, Yasui D, Sugihara F, Mizushima S, Mine T, Kawamata H, Hayashi H, Kumita SI. Emergency endovascular treatment using a Viabahn stent graft for upper and lower extremity arterial bleeding: a retrospective study. CVIR Endovasc 2021; 4:83. [PMID: 34882296 PMCID: PMC8660932 DOI: 10.1186/s42155-021-00273-z] [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] [Subscribe] [Scholar Register] [Received: 09/25/2021] [Accepted: 11/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A Viabahn stent graft (SG) is a heparin-coated self-expandable SG for lower extremity arterial disease that exhibits high flexibility and accuracy in the delivery system. This study aimed to evaluate the short-term efficacy and safety of emergency endovascular treatment (EVT) using a Viabahn SG for upper and lower extremity arterial bleeding (ULEAB). METHODS Consecutive patients with ULEAB who underwent emergency EVT using the Viabahn SG between January 2017 and August 2021 were retrospectively reviewed. The indications for EVT, location of artery, technical success, clinical success, limb ischemia, periprocedural complications, bleeding-related mortality, 30-day mortality, diameter of the target artery, diameter of the SG, neck length, rebleeding, endoleaks, and patency of the SGs at 1, 3, 6, and 12 months were evaluated. RESULTS EVT using the Viabahn SG was performed in 22 patients (mean age, 72.0 ± 13.0 years; 11 men) and 23 arteries (upper, 6; lower, 17). The indications for EVT were pseudoaneurysm (n = 13, 59.1%), extravasation (n = 9, 39.1%), and inadvertent arterial cannulation (n = 1, 4.3%). The anatomical locations of the 23 ULEAB injuries were the brachiocephalic (1 [4.3%]), subclavian (3 [13.0%]), axillary (1 [4.3%]), brachial (1 [4.3%]), common iliac (4 [17.4%]), external iliac (8 [34.8%]), common femoral (2 [8.7%]), superficial femoral (2 [8.7%]), and popliteal (1 [4.3%]) arteries. The technical and clinical success rates were 100%. The rates of limb ischemia, periprocedural complications, and bleeding-related mortality were 0%, whereas the 30-day mortality rate was 22.7%. The mean diameters of the arteries and SGs were 7.7 ± 2.2 and 8.9 ± 2.3 mm, respectively. The mean neck length was 20.4 ± 11.3 mm. No endoleaks or rebleeding occurred during the follow-up period (mean, 169 ± 177 days). Two SG occlusions without limb ischemia occurred in the external iliac and brachial arteries after 1 and 4 months, respectively. Subsequently, cumulative SG patency was confirmed after 1, 3, 6, and 12 months in 91.7%, 91.7%, 81.5%, and 81.5% of patients, respectively. CONCLUSIONS Emergency EVT using the Viabahn SG for ULEAB was effective and safe according to short-term outcomes. Appropriate size selection and neck length are important for successful treatment. SG patency was good after 1, 3, 6, and 12 months.
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Affiliation(s)
- Tatsuo Ueda
- Department of Radiology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan.
| | - Satoru Murata
- Center for Interventional Radiology, Teikyo University Chiba Medical Center, 3426-3 Anesaki, 299-0011, Ichihara City, Chiba, Japan
| | - Hiroyuki Tajima
- Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 1397-1 Yamane, Saitama, 350-1298, Hidaka City, Japan
| | - Hidemasa Saito
- Department of Radiology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan
| | - Daisuke Yasui
- Department of Radiology, Nippon Medical School Musashi Kosugi Hospital, 1-396 Kosugi-machi, Nakahara-ku, 211-8533, Kawasaki City, Kanagawa, Japan
| | - Fumie Sugihara
- Department of Radiology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan
| | - Shohei Mizushima
- Department of Radiology, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Chiba, 270-1694, Inzai City, Japan
| | - Takahiko Mine
- Department of Radiology, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Chiba, 270-1694, Inzai City, Japan
| | - Hiroshi Kawamata
- Department of Radiology, Yokohama Rosai Hospital, 3211 Kozukue-Cho, Kohoku-Ku, 222-0036, Yokohama City, Kanagawa, Japan
| | - Hiromitsu Hayashi
- Department of Radiology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan
| | - Shin-Ichiro Kumita
- Department of Radiology, Nippon Medical School Hospital, 1-1-5 Sendagi, Bunkyo-ku, 113-8603, Tokyo, Japan
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Ueda T, Hayashi H, Ando T, Iwata K, Saito H, Kumita SI. Computed Tomography Attenuation Values of the High-Attenuating Crescent Sign Can Discriminate Between Rupture, Impending Rupture, and Non-Rupture of Aortic Aneurysms. Circ J 2021; 85:2184-2190. [PMID: 34707030 DOI: 10.1253/circj.cj-21-0541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Although the high-attenuating crescent (HAC) sign can indicate aortic aneurysm (AA) impending rupture, the relation of its computed tomography (CT) value to the aneurysmal status remains unclear. This study compared the HAC sign CT-attenuation values among rupture, impending rupture, and non-rupture AA cases.Methods and Results:This included 76 patients (mean age: 77.0 years) diagnosed with HAC sign-associated AA between January 2005 and July 2015. The CT-attenuation values of the HAC sign (H) and aortic lumen (A) using region-of-interest methodology were measured and the H/A ratio was calculated. The study classified patients into the rupture group (R-G, n=36), impending rupture group (IR-G, n=16), and non-rupture group (NR-G, n=24); the H and the H/A ratio were compared among them. Additionally, the H and the H/A ratio cut-offs between the IR-G and NR-G groups were evaluated. The H and the H/A ratio were significantly higher in the R-G and IR-G than in the NR-G (both P<0.001); the H/A ratio was significantly higher in the R-G than in the IR-G (P=0.038). The optimal cut-off for H between the IR-G and NR-G was 50.3 Hounsfield units (area under the curve [AUC]=0.875; sensitivity=87.5%; specificity=87.5%), and that for the H/A ratio was 1.3 (AUC=0.909; sensitivity=91.7%; specificity=87.5%). CONCLUSIONS Among patients with AA, the H and the H/A ratio were significantly higher in cases of rupture and impending rupture than in those of non-rupture.
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Affiliation(s)
- Tatsuo Ueda
- Department of Radiology, Nippon Medical School Hospital
| | | | - Takahiro Ando
- Department of Radiology, Nippon Medical School Hospital
| | - Kotomi Iwata
- Department of Radiology, Nippon Medical School Hospital
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Johnson M, Cho B, Luft A, Alatorre-Alexander J, Geater S, Laktionov K, Vasiliev A, Trukhin D, Kim S, Ursol G, Hussein M, Lim F, Yang C, Araujo L, Saito H, Reinmuth N, Shi X, Poole L, Peters S, Garon E, Mok T. PL02.01 Durvalumab ± Tremelimumab + Chemotherapy as First-line Treatment for mNSCLC: Results from the Phase 3 POSEIDON Study. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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21
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Felip E, Vallieres E, Zhou C, Wakelee H, Bondarenko I, Sakai H, Saito H, Ursol G, Kawaguchi K, Liu Y, Levchenko E, Kislov N, Reck M, Liersch R, McNally V, Zhu Q, Ding B, Bennett E, Gitlitz B, Altorki N. LBA9 IMpower010: Sites of relapse and subsequent therapy from a phase III study of atezolizumab vs best supportive care after adjuvant chemotherapy in stage IB-IIIA NSCLC. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2120] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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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22
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Maeda E, Jwa SC, Kumazawa Y, Saito K, Iba A, Yanagisawa A, Kuwahara A, Saito H, Terada Y, Fukuda T, Ishihara O, Kobayashi Y. P–721 Probability of receiving assisted reproductive technology treatment through out-of-pocket payment and household income: A discrete choice experiment in Japan. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
What is the probability that patients will receive assisted reproductive technology (ART) treatment based on their out-of-pocket payment and income class?
Summary answer
Higher-income patients opted for ART even at a higher cost, whereas an out-of-pocket payment was the most influential determinant in all income groups.
What is known already
Economic disparities affect access to ART treatment in many countries. At the time of this survey, Japan provided partial reimbursement for ART treatment exclusively for those in low- or middle-income classes due to limited governmental budgets. However, the optimal financial support by income class is unknown.
Study design, size, duration
We conducted a discrete choice experiment (DCE) in Japan in January 2020 including 824 women with fertility problems who were recruited via an online social research panel.
Participants/materials, setting, methods
Participants included women aged 25–44 years undergoing fertility diagnosis or treatment. They completed a DCE questionnaire including 16 hypothetical scenarios, created by orthogonal design, to measure six relevant ART attributes (pregnancy rate, risk of adverse effects, number of visits to outpatient clinics, consultation hours, kindness of staff, and out-of-pocket expense) and their relation to treatment choice. We used mixed-effect logistic regression models to estimate the probability of receiving ART treatment for each attribute.
Main results and the role of chance
Of the 1,247 eligible women recruited, 824 completed the survey (66% participation rate). All six attributes significantly influenced treatment preference, with participants valuing out-of-pocket payment the most, followed by pregnancy rates and kindness of staff. The odds ratios of each attribute to receiving ART treatment were 0.58 (95% confidence interval [CI]: 0.57 − 0.59) for out-of-pocket payments per additional 100,000 Japanese yen (JPY; i.e., 800 euros), 1.47 (95% CI: 1.43 − 1.53) for pregnancy rates per additional 5%, and 4.16 (95% CI: 3.73 − 4.64) for kindness of staff, after adjusting for clinical and socioeconomic factors. Significant interactions occurred between high household income (≥8 million JPY) and high out-of-pocket payment (≥500,000 JPY). However, the mean predicted probability of the highest-income patients (i.e., ≥10 million JPY) to receive ART treatment at the average cost without public funding (i.e., 400,000 JPY) was 47% (interquartile range: 18%−76%), whereas that of middle-income patients (i.e., 6–8 million JPY) to receive ART at the average subsidized cost (i.e., 100,000 JPY) was 60% (interquartile range: 33%–88%).
Limitations, reasons for caution
Other attributes not included in our DCE scenarios might be relevant in real-life settings. Choices made in a DCE would not wholly match the actual treatment choices.
Wider implications of the findings: The present DCE suggested that out-of-pocket payment was the primary determinant in patients’ ART decisions. High-income patients were more likely to receive ART treatment even at a high cost, but their ineligibility for government financial support due to their high income might discourage them from receiving treatment.
Trial registration number
NA
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Affiliation(s)
- E Maeda
- Akita University Graduate School of Medicine, Environmental Health Science and Public Health, Akita, Japan
| | - S C Jwa
- Saitama Medical University, Obstetrics and Gynecology, Saitama, Japan
| | - Y Kumazawa
- Akita University Graduate School of Medicine, Obstetrics and Gynecology, Akita, Japan
| | - K Saito
- Tokyo Medical and Dental University, Department of Comprehensive Reproductive Medicine, Tokyo, Japan
| | - A Iba
- Graduate School of Medicine- the University of Tokyo, Department of Public Health, Tokyo, Japan
| | - A Yanagisawa
- Graduate School of Medicine- the University of Tokyo, Department of Public Health, Tokyo, Japan
| | - A Kuwahara
- Graduate School of Biomedical Sciences- Tokushima University, Department of Obstetrics and Gynecology, Tokushima, Japan
| | - H Saito
- Umegaoka Women’s Clinic, ART center, Tokyo, Japan
| | - Y Terada
- Akita University Graduate School of Medicine, Obstetrics and Gynecology, Akita, Japan
| | - T Fukuda
- National Institute of Public Health, Center for Outcomes Research and Economic Evaluation for Health, Saitama, Japan
| | - O Ishihara
- Saitama Medical University, Obstetrics and Gynecology, Saitama, Japan
| | - Y Kobayashi
- Graduate School of Medicine- the University of Tokyo, Department of Public Health, Tokyo, Japan
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Okuda K, Nakajima K, Saito H, Yamashita S, Hashimoto M, Kinuya S. Radiomics analysis of myocardial perfusion SPECT images in patients with cardiomyopathy and heart failure. Eur Heart J Cardiovasc Imaging 2021. [DOI: 10.1093/ehjci/jeab111.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): JSPS KAKENHI Grants
Background
Although myocardial perfusion heterogeneity due to focally damaged cardiomyocytes is observed in single−photon emission computed tomography (SPECT) imaging, a current perfusion defect scoring system does not allow us to provide sufficient diagnostic information for heterogeneity.
Purpose
The aim of this study was to perform radiomics analysis of myocardial perfusion SPECT (MPS) images to investigate the potential to detect myocardial perfusion heterogeneity.
Methods
Patients with hypertrophic cardiomyopathy (n = 3), heart failure (n = 9), and with a low likelihood of coronary artery disease (n =15) (Figure 1), who underwent a rest 99mTc-MIBI myocardial perfusion SPECT, were assessed using a LIFEx software. Four shape−based features, 6 histogram−based features, and 32 textural features were computed. The relevant features for the classification of the patients were selected using the Boruta algorithm, and hierarchical clustering of the selected features using the Spearman correlation coefficient was also performed for the feature reduction. The receiver operating characteristics (ROC) analysis was performed by the support vector machine to calculate the area under the ROC curve (AUC) for the selected features.
Results
Of 40 features, 17 were selected by the classification analysis, and these features were classified into 7 classes by the correlation analysis (Figure 2). The ROC AUCs for 7 features extracted from each class were 0.99, 0.97, 0.96, 0.92, 0.90, 0.86, and 0.83 for the contrast of NDGLDM, the entropy of histogram, ZLNU of GLZLM, the energy of GLCM, the energy of histogram, SZLGE of GLZLM, and the correlation of GLCM, respectively, as compared to 0.39 for a summed rest score.
Conclusions
Radiomics analysis successfully determined the myocardial perfusion heterogeneity in patients with cardiomyopathy and heart failure. It might be promising for the evaluation of myocardial damages that cannot be analyzed by the conventional scoring method.
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Affiliation(s)
- K Okuda
- Kanazawa Medical University, Physics, Ishikawa, Japan
| | - K Nakajima
- Kanazawa University Graduate School of Medicine, Functional Imaging and Artificial Intelligence, Kanazawa, Japan
| | - H Saito
- Kanazawa Medical University, Radiological Technology, Kahoku, Japan
| | - S Yamashita
- Public Central Hospital of Matto Ishikawa, Radiology, Hakusan, Japan
| | - M Hashimoto
- Kanazawa Medical University, Physics, Ishikawa, Japan
| | - S Kinuya
- Kanazawa University Hospital, Nuclear Medicine, Kanazawa, Japan
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Mine T, Yasui D, Saito H, Ueda T, Yokoyama T, Ikeda S, Mizushima S, Happoh S, Kumita SI. Effects of temperature alteration on viscosity, polymerization, and in-vivo arterial distribution of N-butyl cyanoacrylate-iodized oil mixtures. Jpn J Radiol 2021; 39:1111-1118. [PMID: 34106382 PMCID: PMC8568870 DOI: 10.1007/s11604-021-01143-3] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/20/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE Temperature alteration can modify the polymerization of n-butyl cyanoacrylate (NBCA)-iodized oil mixtures during vascular embolization; its effects on viscosity, polymerization time, and intra-arterial distribution of the NBCA-iodized oil mixture were investigated. MATERIALS AND METHODS In vitro, the viscosities of NBCA, iodized oil, and NBCA-iodized oil mixtures (ratio, 1:1-8) were measured at 4-60 ºC using a rotational rheometer. The polymerization times (from contact with blood plasma to stasis) were recorded at 0-60 ºC using a high-speed video camera. In vivo, the 1:2 mixture was injected into rabbit renal arteries at 0, 20, and 60 ºC; intra-arterial distribution of the mixture was pathologically evaluated. RESULTS The mixtures' viscosities decreased as temperature increased; those at 60 ºC were almost four to five times lower than those at 4 ºC. The polymerization time of NBCA and the 1:1-4 mixtures increased as temperature decreased in the 0-30 ºC range; the degree of time prolongation increased as the percentage of iodized oil decreased. The 0 ºC group demonstrated distributions of the mixture within more peripheral arterial branches than the 20 and 60 ºC groups. CONCLUSION Warming reduces the mixture's viscosity; cooling prolongs polymerization. Both can be potential factors to improve the handling of NBCA-iodized oil mixtures for lesions requiring peripheral delivery. Temperature alteration influences the polymerization time, viscosity, and intra-arterial distribution of NBCA-iodized oil mixtures. Warming reduces the viscosity of the mixture, while cooling prolongs polymerization.
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Affiliation(s)
- Takahiko Mine
- Department of Radiology, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan.
| | - Daisuke Yasui
- Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Hidemasa Saito
- Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Tatsuo Ueda
- Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Taro Yokoyama
- Department of Radiology, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan
| | - Shinpei Ikeda
- Department of Radiology, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan
| | - Shohei Mizushima
- Department of Radiology, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan
| | - Seigoh Happoh
- Department of Radiology, Nippon Medical School Chiba Hokusoh Hospital, 1715 Kamagari, Inzai, Chiba, 270-1694, Japan
| | - Shin-Ichiro Kumita
- Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
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Yanagisawa T, Matsumori H, Saito H, Hidaka H, Amitsuka H, Nakamura S, Awaji S, Gorbunov DI, Zherlitsyn S, Wosnitza J, Uhlířová K, Vališka M, Sechovský V. Electric Quadrupolar Contributions in the Magnetic Phases of UNi_{4}B. Phys Rev Lett 2021; 126:157201. [PMID: 33929262 DOI: 10.1103/physrevlett.126.157201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 12/21/2020] [Accepted: 03/02/2021] [Indexed: 06/12/2023]
Abstract
We present acoustic signatures of the electric quadrupolar degrees of freedom in the honeycomb-layer compound UNi_{4}B. The transverse ultrasonic mode C_{66} shows softening below 30 K both in the paramagnetic phase and antiferromagnetic phases down to ∼0.33 K. Furthermore, we traced magnetic field-temperature phase diagrams up to 30 T and observed a highly anisotropic elastic response within the honeycomb layer. These observations strongly suggest that Γ_{6}(E_{2g}) electric quadrupolar degrees of freedom in localized 5f^{2} (J=4) states are playing an important role in the magnetic toroidal dipole order and magnetic-field-induced phases of UNi_{4}B, and evidence some of the U ions remain in the paramagnetic state even if the system undergoes magnetic toroidal ordering.
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Affiliation(s)
- T Yanagisawa
- Department of Physics, Hokkaido University, Sapporo 060-0810, Japan
| | - H Matsumori
- Department of Physics, Hokkaido University, Sapporo 060-0810, Japan
| | - H Saito
- Department of Physics, Hokkaido University, Sapporo 060-0810, Japan
| | - H Hidaka
- Department of Physics, Hokkaido University, Sapporo 060-0810, Japan
| | - H Amitsuka
- Department of Physics, Hokkaido University, Sapporo 060-0810, Japan
| | - S Nakamura
- Institute for Materials Research, Tohoku University, Sendai 980-8577, Japan
| | - S Awaji
- Institute for Materials Research, Tohoku University, Sendai 980-8577, Japan
| | - D I Gorbunov
- Hochfeld-Magnetlabor Dresden (HLD-EMFL) and Würzburg-Dresden Cluster of Excellence ct.qmat, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), 01328 Dresden, Germany
| | - S Zherlitsyn
- Hochfeld-Magnetlabor Dresden (HLD-EMFL) and Würzburg-Dresden Cluster of Excellence ct.qmat, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), 01328 Dresden, Germany
| | - J Wosnitza
- Hochfeld-Magnetlabor Dresden (HLD-EMFL) and Würzburg-Dresden Cluster of Excellence ct.qmat, Helmholtz-Zentrum Dresden-Rossendorf (HZDR), 01328 Dresden, Germany
- Institut für Festkörper- und Materialphysik, TU Dresden, 01062 Dresden, Germany
| | - K Uhlířová
- Department of Condensed Matter Physics, Faculty of Mathematics and Physics, Charles University, 121 16 Prague 2, Czech Republic
| | - M Vališka
- Department of Condensed Matter Physics, Faculty of Mathematics and Physics, Charles University, 121 16 Prague 2, Czech Republic
| | - V Sechovský
- Department of Condensed Matter Physics, Faculty of Mathematics and Physics, Charles University, 121 16 Prague 2, Czech Republic
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Siril YJ, Kouketsu A, Saito H, Takahashi T, Kumamoto H. Immunohistochemical expression levels of cyclin D1 and CREPT reflect the course and prognosis in oral precancerous lesions and squamous cell carcinoma. Int J Oral Maxillofac Surg 2021; 51:27-32. [PMID: 33838964 DOI: 10.1016/j.ijom.2021.03.012] [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: 08/04/2020] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 10/21/2022]
Abstract
Cyclin D1 is the most essential progressive regulator of the cell cycle, and its transcription is enhanced by CREPT (cell cycle-related and expression-elevated protein in tumour). These molecules regulate cell growth, and their aberrant expression can cause malignant transformation. In this study, the expression of these molecules was explored to investigate the molecular alterations in oral precancerous lesions and squamous cell carcinoma. Cyclin D1 and CREPT expression was examined immunohistochemically in tissue specimens from 55 patients with oral epithelial precursor lesions (OEPLs) and 84 patients with oral squamous cell carcinoma (OSCC). Associations between the results and clinicopathological variables were examined. Cyclin D1 and CREPT expression levels were higher in OSCC than in OEPLs. Furthermore, there were statistically significant differences in cyclin D1 expression among the different grades of OEPLs and OSCC lesions. In OSCC, there were statistically significant differences in CREPT expression according to sex, T stage, and degree of differentiation. In addition, the expression of both molecules was significantly correlated with postoperative metastasis and modes of invasion. The expression of cyclin D1 and CREPT was found to depend upon the state of development and progression of the oral epithelial lesions, and clinicopathological behaviours might be affected by these molecules in OSCC.
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Affiliation(s)
- Y J Siril
- Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan; Division of Oral Pathology, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan.
| | - A Kouketsu
- Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - H Saito
- Division of Oral Pathology, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - T Takahashi
- Division of Oral and Maxillofacial Surgery, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
| | - H Kumamoto
- Division of Oral Pathology, Department of Disease Management Dentistry, Tohoku University Graduate School of Dentistry, Sendai, Japan
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Ueda T, Tajima H, Murata S, Saito H, Yasui D, Sugihara F, Mine T, Miki I, Kurita J, Morota T, Ishii Y, Yokobori S, Kumita SI. A Comparison of Outcomes Based on Vessel Type (Native Artery vs. Bypass Graft) and Artery Location (Below-Knee Artery vs. Non-Below-Knee Artery) Using a Combination of Multiple Endovascular Techniques for Acute Lower Limb Ischemia. Ann Vasc Surg 2021; 75:205-216. [PMID: 33819584 DOI: 10.1016/j.avsg.2021.02.023] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 02/08/2021] [Accepted: 02/12/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND To evaluate outcomes of endovascular treatment (EVT) using a combination of multiple endovascular techniques for acute lower limb ischemia (ALLI) and to compare outcomes based on vessel type and artery location. METHODS A total of 95 consecutive patients with ALLI (mean age, 72.0 years; 65 males; 104 lower limbs) who received emergency EVT using a combination of multiple endovascular techniques including thrombolysis, aspiration thrombectomy, stenting, and balloon angioplasty with or without surgical thromboembolectomy, between January 2005 and December 2017 were included. Vessel type was classified into native artery occlusion (native occlusion) and bypass graft occlusion (graft occlusion), including prosthetic and vein graft. Additionally, native arteries were categorized into below-knee occlusion and non-below-knee occlusion. Technical success, perioperative death (POD), ALLI-related death, amputation, amputation-free survival (AFS), and complications were compared according to vessel type (native occlusion vs. graft occlusion) and artery location (below-knee occlusion vs. non-below-knee occlusion). RESULTS Of all patients with ALLI, 16.8% underwent a single endovascular technique, whereas 83.2% underwent a combination of multiple endovascular techniques. The technicalsuccess, POD, and ALLI-related death rates in the total number of patients were 94.7%, 11.6%, and 4.2%, respectively. A total of 67 patients (75 limbs) and 28 patients (29 limbs) were classified as having native occlusion and graft occlusion (prosthetic, 24 limbs; vein, 5 limbs), respectively. No significant differences in technical success (native occlusion: 92.5% vs. graft occlusion: 100%), POD (14.9% vs. 3.6%), and ALLI-related death (6.0% vs. 0%) were noted between native occlusion and graft occlusion. However, the 30-day AFS rate of native occlusion was significantly lower than that of graft occlusion (75.2% vs. 96.3%, P=0.01). The amputation rate (P=0.03) and AFS rate (P=0.03) of below-knee occlusion were significantly worse for below-knee occlusion patients than for non-below-knee occlusion patients. CONCLUSIONS EVT using multiple endovascular techniques for ALLI is effective and safe. A combination of multiple endovascular techniques is crucial for successful treatment. However, native occlusion may have a lower AFS rate than graft occlusion, and below-knee occlusion may have a higher risk of amputation than non-below-knee occlusion.
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Affiliation(s)
- Tatsuo Ueda
- Department of Radiology, Nippon Medical School Hospital, Bunkyo, Tokyo, Japan.
| | - Hiroyuki Tajima
- Department of Diagnostic Imaging, Saitama Medical University International Medical Center, Hidaka, Saitama, Japan
| | - Satoru Murata
- Center for Interventional Radiology, Teikyo University Chiba Medical Center, Ichihara, Chiba, Japan
| | - Hidemasa Saito
- Department of Radiology, Nippon Medical School Hospital, Bunkyo, Tokyo, Japan
| | - Daisuke Yasui
- Department of Radiology, Nippon Medical School Hospital, Bunkyo, Tokyo, Japan
| | - Fumie Sugihara
- Department of Radiology, Nippon Medical School Hospital, Bunkyo, Tokyo, Japan
| | - Takahiko Mine
- Department of Radiology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Chiba, Japan
| | - Izumi Miki
- Department of Radiology, Nippon Medical School Hospital, Bunkyo, Tokyo, Japan
| | - Jiro Kurita
- Department of Cardiovascular Surgery, Nippon Medical School, Bunkyo, Tokyo, Japan
| | - Tetsuro Morota
- Department of Cardiovascular Surgery, Nippon Medical School, Bunkyo, Tokyo, Japan
| | - Yosuke Ishii
- Department of Cardiovascular Surgery, Nippon Medical School, Bunkyo, Tokyo, Japan
| | - Shoji Yokobori
- Department of Emergency and Critical Care Medicine, Nippon Medical School, Bunkyo, Tokyo, Japan
| | - Shin-Ichiro Kumita
- Department of Radiology, Nippon Medical School Hospital, Bunkyo, Tokyo, Japan
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Onozawa H, Nemoto D, Miura J, Eriguchi D, Adachi H, Nagashima T, Ito H, Saito H, Yokose T, Nakayama H, Iwazaki M. P07.07 Computed Tomography of Lymph Nodes to Predict Occult pN2 Disease in Non-Small-Cell Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.418] [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: 10/21/2022]
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Affiliation(s)
- K Sakai
- Department of General Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - Y Tomoda
- Department of General Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
| | - H Saito
- Department of General Medicine and Primary Care, Yamaguchi University Hospital, 1-1-1, Minamikogushi, Ube shi, Yamaguchi, Japan
| | - K Tanaka
- Department of General Medicine, Saiseikai Fukuoka General Hospital, Fukuoka, Japan
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Takemoto H, Kado A, Kitani H, Katsuura C, Mizuno S, Saito H, Takachi K. A study on the current state of nutrition therapy for end-stage cancer patients based on the results of nutritionday. Clin Nutr ESPEN 2020. [DOI: 10.1016/j.clnesp.2020.09.446] [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: 11/29/2022]
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31
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Nakano T, Aoyama H, Onodera S, Matsumo Y, Shimamoto S, Igaki H, Matsuo M, Oya N, Ohta A, Saito H, Maruyama K, Kanemoto A, Sakurai T, Tanaka T, Kitamura N, Akazawa K, Maebayashi K. Reduced-Dose Whole Brain Radiation Therapy Combined With Stereotactic Irradiation For Solitary Or Oligo Brain Metastases Aiming At Minimizing Deterioration Of Neurocognitive Function Without Compromising Intracranial Tumor Control: Preliminary Results. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2057] [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: 10/23/2022]
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Saito K, Matsue Y, Kamiya K, Saito H, Ogasahara Y, Kitai T, Konishi M, Maekawa E, Iwata K, Jujo K, Wada H, Kasai T, Nagamatsu H, Momomura S, Kagiyama N. Prognostic significance of 2019 Asian Working Group for Sarcopenia update on definition of sarcopenia. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background/Introduction
Sarcopenia plays a major role in the pathophysiology of frailty and is associated with worse outcome in the elderly population including patients with heart failure. A recent update of the most common definition of sarcopenia in Asia, Asian Working Group for Sarcopenia (AWGS2019), included significant changes in the diagnostic algorithm with newly dividing sarcopenia into severe and “non-severe” sarcopenia.
Purpose
The objective of this study was to evaluate the differences between AWGS2014 and AWGS2019 in patients with heart failure.
Methods
In the multicenter prospective FRAGILE-HF registry, which included elderly (≥65 years old) patients who were hospitalized with heart failure, we studied 865 patients (80±8 years old, 42% female). All-cause death in 1-year follow-up was tracked.
Results
Based on the original version of AWGS (AWGS2014), 183 patients (21%) were diagnosed with sarcopenia, which was associated with higher age, lower physical performance, less muscle mass, and greater heart failure risk (all p<0.001) as well as higher rate of all-cause death (HR 1.90, p=0.004 after adjustment by multivariable regression). Those patients with sarcopenia by AWGS2014 were reclassified mainly to severe sarcopenia (155, 84.7%) by AWGS2019, and 25 (13.7%) and 2 (1.1%) were classified into sarcopenia and non-sarcopenia. Meanwhile, 24 (3.5%) and 4 (0.6%) of patients without sarcopenia by AWGS2014 were reclassified into sarcopenia and severe sarcopenia, respectively. Although severe sarcopenia by AWGS2019 was associated with higher age, lower physical performance, less muscle mass, and greater heart failure risk (all p<0.001), patients with “non-severe” sarcopenia was rather younger (p<0.001) and had better physical performance (p=0.021) despite less muscle mass (p<0.001) than those without sarcopenia. Multivariate Cox analysis demonstrated severe sarcopenia by AWGS2019 was an independent prognostic factor (HR 1.77, p=0.014), but “non-severe” sarcopenia was not (HR 1.52, p=0.37). The prognosis of patients who were reclassified from non-sarcopenia to sarcopenia or severe sarcopenia were comparable to those remained non-sarcopenia. When added to other risk factors, the prognostic predictability of AWGS2019 was significantly lower than AWGS2014 (net reclassification improvement −0.26, p=0.025).
Conclusions
About a half of “non-severe” sarcopenia in AWGS2019 were patients without sarcopenia in AWGS2014. The prognosis of such patients who were newly diagnosed as sarcopenia was good, resulting in low overall prognostic predictability of AWGS2019. A further consideration for diagnostic algorithms of sarcopenia may be warranted in patients with heart failure.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Japan Heart Foundation
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Affiliation(s)
- K Saito
- The Sakakibara Heart Institute of Okayama, Cardiac rehabilitation, Okayama, Japan
| | - Y Matsue
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - K Kamiya
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - H Saito
- Kameda Medical Center, Chiba, Japan
| | - Y Ogasahara
- The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - M Konishi
- Yokohama City University Medical Center, Yokohama, Japan
| | - E Maekawa
- Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan
| | - K Iwata
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - K Jujo
- Nishiarai Heart Center, Tokyo, Japan
| | - H Wada
- Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - T Kasai
- Juntendo University Graduate School of Medicine, Tokyo, Japan
| | | | - S Momomura
- Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - N Kagiyama
- West Virginia Institute Heart and Vascular Institute, Morgantown, United States of America
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Konishi M, Kagiyama N, Saito H, Saito K, Ogasahara Y, Maekawa E, Kitai T, Momomura S, Tamura K, Kimura K, Kamiya K, Matsue Y. Negative impact of skeletal muscle impairment in older patients with heart failure with reduced versus preserved ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1143] [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/Introduction
Reduced functional capacity is an important phenotype of heart failure (HF), even though it may be considered multifactorial, especially in HF with preserved ejection fraction (HFpEF). Impairment in skeletal muscle may be one of extra-cardiac factors for reduced functional capacity and subsequent poor outcome.
Purpose
We sought to investigate the impact of the impairment in skeletal muscle, defined by the cut-offs proposed by the international consensus, on functional capacity and clinical outcome, in HF patients with preserved and reduced EF (HFrEF).
Methods
This is a multicenter prospective study including 1317 consecutive older (≥65 years) hospitalized patients with HF [HFpEF (ejection fraction ≥45%, n=675, 82±7 years, 46.4% male) and HFrEF (ejection fraction <45%, n=642, 78±8 years, 68.4% male)].
Results
HFrEF patients were more likely to have low skeletal muscle mass measured by bioelectrical impedance analysis (30.9% vs 22.1%, p=0.003) whereas less likely to have low muscle strength (handgrip strength; 62.9% vs 73.8%, p<0.001) than HFpEF, resulting in similar prevalence of sarcopenia between the two groups (21.6% vs 18.1%, p=0.19). In HFrEF, presence of sarcopenia was an independent predictor of reduced functional capacity assessed by a 6-minute walk distance (standardized beta=−0.093, p=0.039 in multivariate linear regression analysis) and 1-year mortality (adjusted hazard ratio (aHR) and 95% CI; 2.14 (1.22–3.70), p=0.009 in multivariate Cox-regression analysis). In patients with HFpEF, sarcopenia could predict mortality (aHR and 95% CI; 2.23 (1.23–3.91), p=0.009), though its association with reduced functional capacity was not significant after multivariate adjustment (standardized beta=−0.059, p=0.20). Kaplan-Meier survival curves in HFpEF and HFrEF are shown (Figure).
Conclusion(s)
In older patients with HF, sarcopenia was similarly contributed to mortality in HFpEF and HFrEF whereas its influence on functional capacity was pronounced in HFrEF.
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Japan Heart Foundation Research Grant
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Affiliation(s)
- M Konishi
- Yokohama City University Hospital, Yokohama, Japan
| | - N Kagiyama
- The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - H Saito
- Kameda Medical Center, Kamogawa, Japan
| | - K Saito
- The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Y Ogasahara
- The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Sagamihara, Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - S Momomura
- Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - K Tamura
- Yokohama City University Hospital, Yokohama, Japan
| | - K Kimura
- Yokohama City University Medical Center, Yokohama, Japan
| | - K Kamiya
- Kitasato University School of Medicine, Sagamihara, Japan
| | - Y Matsue
- Juntendo University School of Medicine, Tokyo, Japan
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Kanazawa M, Toyoda M, Seki T, Iguchi A, Takahashi S, Kagaya Y, Sato K, Saito H, Ito K, Miura M, Kondo M, Kawatsu S, Endo H, Oda K, Nakamura A. Chronotropic incompetence and exercise capacity after mitral valve surgery: the importance of blood hemoglobin level. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Chronotropic incompetence (CI) is sometimes observed during exercise training of cardiac rehabilitation in patients with cardiac surgery, however, little is known concerning the differences between patients with mitral valve (MV) and aortic valve (AV) surgery.
Purpose
Because the possibility exists that cardiac sympathetic nerves might be impaired by left atrium incision, we hypothesized that the incidence of CI was higher in patients with MV surgery (Mitral Valve Replacement and Mitral Valvuloplasty) as compared with patients with AV surgery (Aortic Valve Replacement). And if so, which factor determines the exercise capacity of patients after MV surgery. We thus aimed this study to elucidate the hypothesis with cardiopulmonary exercise testing (CPX).
Methods
We performed CPX by ramp loading with ergometer exercise in total 61 patients who had undergone elective cardiac valve operation (25 patients with MV surgery, age 59.2±9.9 years; 36 patients with AV surgery, age 64.6±12.3 years). We analyzed chronotropic response index (CRI), peak oxygen uptake (peak VO2/W), anaerobic threshold (AT), and peak oxygen pulse (peak VO2/HR) with CPX, and blood hemoglobin concentration (Hb).
Results
The value of CRI was significantly decreased in the patients with MV surgery compared with those with AV surgery (MV; 0.19±0.10 vs. AV; 0.41±0.17, p<0.001). Peak VO2, peak VO2/HR and Hb were not significantly different between patients with MV and those with AV surgery. Patients with MV surgery showed correlations between peak VO2 and Hb (r=0.45, p<0.05), AT and Hb (r=0.52, p<0.01), and a strong correlation between peak VO2 and peak VO2/HR (r=0.63, p<0.001), but not in those with AV surgery.
Conclusions
The present study demonstrated that higher incidence of CI was shown in patients with MV surgery as compared with those with AV surgery. The exercise capacity of patients with MV surgery was determined by peak VO2/HR and Hb. These results suggest that 1) left atrium incision impairs cardiac sympathetic nerves and causes CI, 2) peak VO2/HR which is consisted of arterio-venous oxygen difference and Hb is critical indicator for exercise capacity in patients with MV surgery with CI.
Main results
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Kanazawa
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - M Toyoda
- Iwate Prefectural Central Hospital, Department of Rehabilitation, Morioka, Japan
| | - T Seki
- Iwate Prefectural Central Hospital, Department of Rehabilitation, Morioka, Japan
| | - A Iguchi
- Iwate Prefectural Central Hospital, Department of Rehabilitation, Morioka, Japan
| | - S Takahashi
- Iwate Prefectural Central Hospital, Department of Rehabilitation, Morioka, Japan
| | - Y Kagaya
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - K Sato
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - H Saito
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - K Ito
- Iwate Prefectural Central Hospital, Department of Cardiovascular Surgery, Morioka, Japan
| | - M Miura
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - M Kondo
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - S Kawatsu
- Iwate Prefectural Central Hospital, Department of Cardiovascular Surgery, Morioka, Japan
| | - H Endo
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
| | - K Oda
- Iwate Prefectural Central Hospital, Department of Cardiovascular Surgery, Morioka, Japan
| | - A Nakamura
- Iwate Prefectural Central Hospital, Department of Cardiology, Morioka, Japan
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Jujo K, Kagiyama N, Kamiya K, Saito H, Saito K, Ogasahara Y, Maekawa E, Konishi M, Kitai T, Iwata K, Wada H, Kasai T, Nagamatsu H, Ozawa T, Matsue Y. Social frailty provides additive prognostic impact on one-year outcome in aged patients with congestive heart failure. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1152] [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
Frailty is associated with multisystem declines in physiologic reserve and increased vulnerability to stressors, resulting in increased risks of adverse clinical outcomes in patients with heart failure (HF). Although frailty is conceptualized as an accumulation of deficits in multiple areas, most of the studies have focused mainly on physical frailty, and the social domains is one of the least investigated area.
Objectives
We prospectively evaluated the incidence and prognostic implication of social frailty (SF) in older patients with HF.
Methods
The FRAGILE-HF is a multicenter, prospective cohort study including patients hospitalized for HF and aged ≥65 years old. We defined SF by Makizako's 5 items, which are 5 questions proposed and validated to be associated with future disability. The primary endpoint of this study was a composite of death from any cause and rehospitalization due to HF. The impact of SF on all-cause mortality alone was also evaluated.
Results
Among 1,240 hospitalized HF patients, 5 simple questions revealed that 825 (66.5%) were in SF. During 1-year observation period after the discharge, the combined endpoint was observed in 399 (32.2%) patients, and 145 (11.7%) patients died. Kaplan-Meier analysis showed that SF patients had significantly higher rates of both the combined endpoint and all-cause mortality than those without SF (Log-rank test: p<0.05 for both, Figures). Moreover, SF remained independently associated with higher event rate of the combined endpoint (hazard ratio: 1.30; 95% confidence interval: 1.02 to 1.66; p=0.038) and all-cause mortality (hazard ratio: 1.53; 95% confidence interval: 1.01 to 2.30; p=0.044), even after adjusting for other covariates. Significant incremental prognostic value was shown when information on social frailty was added to known risk factors for combined endpoint (NRI: 0.189, 95% confidence interval: 0.063–0.316, p=0.003) and all-cause mortality (NRI: 0.234, 95% confidence interval: 0.073–0.395, p=0.004).
Conclusions
Among older hospitalized patients with heart failure, two-thirds of the population was with SF. Evaluating SF provides additive prognostic information in elderly patients with heart failure.
Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Novartis Pharma Research Grants, Japan Heart Foundation Research Grant
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Affiliation(s)
- K Jujo
- Tokyo Women's Medical University, Tokyo, Japan
| | - N Kagiyama
- West Virginia Institute Heart and Vascular Institute, Morgantown, United States of America
| | - K Kamiya
- Kitasato University, Rehabilitation, Tokyo, Japan
| | - H Saito
- Kameda Medical Center, Chiba, Japan
| | - K Saito
- The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Y Ogasahara
- The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - E Maekawa
- Kitasato University, Nursing, Tokyo, Japan
| | - M Konishi
- Yokohama City University Medical Center, Yokohama, Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - K Iwata
- Kobe City Medical Center General Hospital, Kobe, Japan
| | - H Wada
- Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - T Kasai
- Juntendo University School of Medicine, Tokyo, Japan
| | - H Nagamatsu
- Tokai University School of Medicine, Kanagawa, Japan
| | - T Ozawa
- Odawara Municipal Hospital, Rehabilitation, Kanagawa, Japan
| | - Y Matsue
- Juntendo University School of Medicine, Tokyo, Japan
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Ueda T, Murata S, Saito H, Miki I, Yasui D, Sugihara F, Shimizu W, Kumita SI. Balloon-assisted Transcatheter arterial embolization using N-butyl cyanoacrylate for iatrogenic arterial bleeding by groin puncture: a new technology. CVIR Endovasc 2020; 3:42. [PMID: 32830301 PMCID: PMC7443418 DOI: 10.1186/s42155-020-00132-3] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 06/18/2020] [Indexed: 12/02/2022] Open
Abstract
Background Balloon-assisted transcatheter arterial embolization (TAE) using n-butyl cyanoacrylate (NBCA) and lipiodol (Lp) mixture is a new endovascular treatment technique for iatrogenic arterial bleeding by groin puncture. It is less invasive compared to surgical repair, and NBCA migration into the circulation can be prevented by temporary balloon occlusion of the parent artery without ultrasound-guidance. This study aimed to report on the technical aspects and evaluate the efficacy and safety of fluoroscopically guided balloon-assisted transcatheter arterial embolization using NBCA for iatrogenic arterial bleeding by groin puncture. Materials and methods The study included five patients (mean age 54.6 years; 3 male and 2 female) with iatrogenic arterial bleeding by groin puncture. We performed transcatheter arterial embolization using NBCA while occluding the responsible artery with a balloon catheter during the embolization to prevent NBCA migration. Two sheaths were inserted into the common femoral artery. A microcatheter was advanced into the pseudoaneurysm or extravasation via the contralateral sheath. A balloon catheter was advanced into the responsible artery until the balloon portion covered the leakage site via another sheath. After balloon inflation, the NBCA and Lip mixture was slowly injected until the pseudoaneurysm, or the extravasation was filled without touching the balloon. The microcatheter was removed immediately after the filling. We assessed technical success, overall success, and complications. Results The injured arteries were the external iliac artery (n = 1), the common femoral artery (n = 2), and the proximal portion of the superficial femoral artery (n = 2). NBCA was injected once in four cases and twice in one case where complete hemostasis could not be achieved with one injection. The technical and overall success rate was 100% with no complications, including distal embolization of NBCA. Conclusions Balloon-assisted TAE using NBCA is a feasible, effective, and safe treatment for iatrogenic arterial bleeding by groin puncture. It may also be applicable in other arterial bleeding situations where the potential risk of distal embolization can be decreased by applying the balloon-assisted technique.
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Affiliation(s)
- Tatsuo Ueda
- Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan.
| | - Satoru Murata
- Center for Interventional Radiology, Teikyo University Chiba Medical Center, 3426-3 Anesaki, Ichihara-City, Chiba, 299-0011, Japan
| | - Hidemasa Saito
- Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Izumi Miki
- Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Daisuke Yasui
- Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Fumie Sugihara
- Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Wataru Shimizu
- Department of Cardiovascular Medicine, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
| | - Shin-Ichiro Kumita
- Department of Radiology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo, 113-8603, Japan
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Fukumoto K, Fujita K, Saito H, Sekio Y, Yamazaki M. Effect of temperature history on swelling behavior of V-Fe binary alloy irradiated in a fast reactor Joyo. Nuclear Materials and Energy 2020. [DOI: 10.1016/j.nme.2020.100760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Saito H, Tanimoto T, Kami M, Suzuki Y, Morita T, Morita M, Yamamoto K, Shimada Y, Tsubokura M, Endo M. New physician specialty training system impact on distribution of trainees in Japan. Public Health 2020; 182:143-150. [PMID: 32305513 DOI: 10.1016/j.puhe.2020.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 01/13/2020] [Accepted: 02/07/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The problem of uneven distribution of medical services and inequitable distribution of physicians is drawing much attention worldwide. Revealing how changes in the specialty training system in Japan have affected the distribution of doctors could help us understand this problem. In 2018, a new and standardized specialty training system was implemented by the Japanese Medical Specialty Board, which is recognized by the Ministry of Health, Labor and Welfare. The purpose of this study was to investigate how this new system has affected the geographical distribution of doctors commencing specialty training (trainees) and choice of specialty in Japan. STUDY DESIGN Retrospective observational study. METHODS The change in the number of trainees between the control period (2012-2014) and 2018 was investigated, taking into account the prefecture and specialty selected. Population, the proportion of residents aged 65 years or older (aging rate), and the total number of overall doctors in each prefecture were considered as the background characteristics of each prefecture. We created a Lorenz curve and calculated the Gini coefficient for the distribution of trainees. RESULTS In 2018, the number of trainees per 100,000 population increased to 6.6 nationwide compared with 5.5 during the control period. The number of trainees per 100,000 population in 2018 increased in prefectures with a large population of ≧ 2,000,000, a low aging rate (<27%), and a high doctor density (≧ 250 doctors per 100,000 population). The Gini coefficient showed an increase to 0.226 in 2018 compared with only 0.160 during the control period. CONCLUSIONS After the implementation of the new training system, there was an increase in the number of doctors enrolling in specialty programs, and the specialties other than internal medicine and surgery have attracted more trainees. Inequality in the distribution of doctors between urban and rural prefectures worsened. This indicates the need to explore new ways of balancing distribution while maintaining optimal opportunities for specialist training.
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Affiliation(s)
- H Saito
- Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
| | - T Tanimoto
- Department of Internal Medicine, Navitas Clinic, Tachikawa, Tokyo, Japan
| | - M Kami
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Y Suzuki
- Department of Obstetrics and Gynecology, Tone Central Hospital, Numata, Gunma, Japan
| | - T Morita
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, Japan
| | - M Morita
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - K Yamamoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - Y Shimada
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - M Tsubokura
- Department of Internal Medicine, Soma Central Hospital, Soma, Fukushima, Japan
| | - M Endo
- Support Office for Medical Education and Trainings, Sendai Kousei Hospital, Sendai, Miyagi, Japan
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Yoshioka H, Shimokawa M, Seto T, Morita S, Yatabe Y, Okamoto I, Tsurutani J, Satouchi M, Hirashima T, Atagi S, Shibata K, Saito H, Toyooka S, Yamamoto N, Nakagawa K, Mitsudomi T. Final overall survival results of WJTOG3405, a randomized phase III trial comparing gefitinib versus cisplatin with docetaxel as the first-line treatment for patients with stage IIIB/IV or postoperative recurrent EGFR mutation-positive non-small-cell lung cancer. Ann Oncol 2019; 30:1978-1984. [PMID: 31553438 DOI: 10.1093/annonc/mdz399] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [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] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Primary analysis of the phase III study WJTOG 3405 demonstrated superiority of progression-free survival (PFS) for gefitinib (G) in patients treated with the epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI) gefitinib compared with cisplatin plus docetaxel (CD) as the first-line treatment of stage IIIB/IV or postoperative recurrent EGFR mutation-positive non-small-cell lung cancer. This report presents final overall survival (OS) data. PATIENTS AND METHODS Patients were randomized between G (250 mg/day orally) and cisplatin (80 mg/m2 intravenously) plus docetaxel (60 mg/m2 i.v.), administered every 21 days for three to six cycles. After the exclusion of 5 patients, 172 patients (86 in each group, modified intention-to-treat population) were included in the survival analysis. OS was re-evaluated using updated data (data cutoff, 30 September 2013; median follow-up time 59.1 months). The Kaplan-Meier method and the log-rank test were used for analysis, and hazard ratios (HRs) for death were calculated using the Cox proportional hazards model. RESULTS OS events in the G group and CD group were 68 (79.1%) out of 86 and 59 (68.6%) out of 86, respectively. Median survival time for G and CD were 34.9 and 37.3 months, respectively, with an HR of 1.252 [95% confidence interval (CI): 0.883-1.775, P = 0.2070]. Multivariate analysis identified postoperative recurrence and stage IIIB/IV disease as independent prognostic factors, with an HR of 0.459 (95% CI: 0.312-0.673, P < 0.001). Median survival time (postoperative recurrence versus stage IIIB/IV disease) were 44.5 and 27.5 months in the G group and 45.5 and 32.8 months in the CD group, respectively. CONCLUSION G did not show OS benefits over CD as the first-line treatment. OS of patients with postoperative recurrence was better than that of stage IIIB/IV disease, even though both groups had metastatic disease.This study was registered with UMIN (University Hospital Medical Information Network in Japan), number 000000539.
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Affiliation(s)
- H Yoshioka
- Department of Thoracic Oncology, Kansai Medical University Hospital, Hirakata
| | - M Shimokawa
- Department of Cancer Information Research, National Hospital Organization Kyushu Cancer Center, Fukuoka; Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Ube
| | - T Seto
- Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka
| | - S Morita
- Department of Biomedical Statistics and Bioinformatics, Kyoto University Graduate School of Medicine, Kyoto
| | - Y Yatabe
- Department of Pathology and Molecular Genetics, Aichi Cancer Center Hospital, Nagoya
| | - I Okamoto
- Research Institute for Diseases of the Chest, Graduate School of Medical Sciences, Kyusyu University, Fukuoka
| | - J Tsurutani
- Advanced Cancer Translational Research Institute, Showa University, Tokyo
| | - M Satouchi
- Department of Thoracic Oncology, Hyogo Cancer Center, Akashi
| | - T Hirashima
- Department of Thoracic Oncology, Osaka Habikino Medical Center, Habikino
| | - S Atagi
- Department of Thoracic Oncology, National Hospital Organization Kinki-chuo Chest Medical Center, Sakai
| | - K Shibata
- Department of Medical Oncology, Kouseiren Takaoka Hospital, Takaoka
| | - H Saito
- Department of Respiratory Medicine, Aichi Cancer Center Aichi Hospital, Okazaki
| | - S Toyooka
- Department of General Thoracic Surgery and Breast and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama
| | - N Yamamoto
- Internal Medicine III, Wakayama Medical University Hospital, Wakayama
| | - K Nakagawa
- Department of Medical Oncology, Kindai University Hospital, Osaka-Sayama
| | - T Mitsudomi
- Division of Thoracic Surgery, Department of Surgery, Kindai University Hospital, Osaka-Sayama, Japan.
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Kawamata H, Tajima H, Ueda T, Saito H, Yasui D, Kaneshiro T, Takenoshita N, Mizushima S, Mine T, Kurita J, Ishii Y, Morota T, Nitta T, Maruyama Y, Imura H, Nishina D, Fujii M, Bessho R. Long-term outcomes of endovascular aortic aneurysm repair with the Zenith AAA endovascular graft: a single-center study. Jpn J Radiol 2019; 38:77-84. [DOI: 10.1007/s11604-019-00892-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 10/14/2019] [Indexed: 11/24/2022]
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Kondo T, Nakahara Y, Usui R, Murakami S, Kato T, Saito H, Yamada K. EP1.01-72 Treatment Outcome of 2nd Generation EGFR-TKI for Non-Small Cell Lung Cancer. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2045] [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: 11/25/2022]
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Saito H, Yamashita M, Endo Y, Mizukami A, Yoshioka K, Hashimoto T, Koseki S, Shimode Y, Kitai T, Maekawa E, Kamiya K, Matsue Y. P4516Incremental prognostic values of cognitive impairment diagnosed by mini-mental state examination and mini-cog in older hospitalized patients with heart failure. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0909] [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
Introduction
Cognitive impairment (CI) is associated with worse prognosis in patients with heart failure, especially in the elderly; however, its incremental prognostic ability in pre-existing prognostic models has not been well elucidated. Moreover, although some tools have been proposed for evaluating cognitive function, their difference in prognostic prediction has not been explicitly compared.
Methods
A total of 352 heart failure patients aged ≥75 years admitted to three hospitals were evaluated for their cognitive function using the Mini-Mental State Examination (MMSE) and Mini-cog during index hospitalization. We diagnosed CI if MMSE and Mini-cog were ≤23 and ≤2, respectively. The primary endpoint was all-cause death.
Results
The median age of the entire cohort was 85 (IQR: 80–88) years, and 47.7% of the subjects were male. Based on the MMSE and Mini-cog, the CI was diagnosed in 167 (47.4%) and 159 (45.2%) patients, respectively. The two diagnostic tools showed poor to moderate agreement (Cohen's kappa coefficient: 0.37, 95% CI: 0.27–0.47). During the follow-up period of median 346 (IQR: 195–489) days, 53 patients (15.1%) died. Although the Kaplan-Meier analysis showed that CI diagnosed using Mini-cog (CI-MC) was associated with significantly higher mortality (P=0.001), this association was not significant for CI diagnosed using MMSE (CI-MMSE) (P=0.059). On multivariate Cox regression analysis, CI-MMSE and CI-MC were individually associated with worse prognosis in older heart failure patients even after adjustment for Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) risk model and log B-type natriuretic peptide levels (CI-MMSE, HR: 2.05 [95% CI: 1.16–3.61]; and CI-MC, HR: 2.57 [95% CI: 1.46–4.53]). The receiver operating characteristic curve analysis for Mini-cog showed significantly higher area under the curve (AUC) than that for MMSE (0.61 vs. 0.52, p=0.045). To test the incremental prognostic capability, models were constructed by individually adding each score to the MAGGIC risk model, and the net reclassification improvement (NRI) and integrated discrimination improvement (IDI) were evaluated. CI-MMSE did not show incremental prognostic predictability (NRI: 0.28, p=0.069; IDI: 0.01, p=0.090), whereas CI-MC (NRI: 0.45, p=0.001; IDI: 0.03, p=0.001) did. Adding CI-MC instead of CI-MMSE to the MAGGIC risk model showed significant reclassification improvement (NRI: 0.45, p=0.002, IDI: 0.02, p=0.041).
Conclusion
In older patients with heart failure, CI defined by Mini-Cog is superior in providing additive prognostic value than that defined by CI based on MMSE.
Acknowledgement/Funding
This study is partially funded by Japan Heart Foundation Research Grant and Novartis Research Grants.
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Affiliation(s)
- H Saito
- Kameda Medical Center, Department of Rehabilitaion, Kamogawa, Japan
| | - M Yamashita
- Kitasato University Graduate School of Medical Sciences, Department of Rehabilitation Sciences, Sagamihara, Japan
| | - Y Endo
- Kameda Medical Center, Department of Rehabilitaion, Kamogawa, Japan
| | - A Mizukami
- Kameda Medical Center, Department of Cardiology, Kamogawa, Japan
| | - K Yoshioka
- Kameda Medical Center, Department of Cardiology, Kamogawa, Japan
| | - T Hashimoto
- Kameda Medical Center, Department of Pharmacy, Kamogawa, Japan
| | - S Koseki
- Kitasato University Hospital, Department of Rehabilitation, Sagamihara, Japan
| | - Y Shimode
- Kobe City Medical Center General Hospital, Department of Rehabilitation, Kobe, Japan
| | - T Kitai
- Kobe City Medical Center General Hospital, Department of Cardiovascular Medicine, Kobe, Japan
| | - E Maekawa
- Kitasato University School of Medicine, Department of Cardiovascular Medicine, Sagamihara, Japan
| | - K Kamiya
- Kitasato University, Department of Rehabilitation, School of Allied Health Sciences, Sagamihara, Japan
| | - Y Matsue
- Juntendo University Graduate School of Medicine, Cardiovascular Respiratory Sleep Medicine, Tokyo, Japan
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Saito H, Hayashi H, Ueda T, Mine T, Kumita SI. Changes in Aortic Wall Thickness at a Site of Entry Tear on Computed Tomography before Development of Acute Aortic Dissection. Ann Vasc Dis 2019; 12:379-384. [PMID: 31636750 PMCID: PMC6766757 DOI: 10.3400/avd.oa.19-00051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objective: To determine if there are changes in the aortic wall before acute aortic dissection (AD) that can be observed on contrast-enhanced computed tomography (CECT). Materials and Methods: Twenty-two patients with AD who underwent CECT before developing AD were retrospectively identified and enrolled as the AD group. Twenty-five consecutive patients who underwent CECT and did not develop AD were enrolled as the control group. In the AD group, the site of entry tear was detected on CECT images; the aortic wall thickness at this site, defined as the dissection-related wall thickness (D-T), was then measured on CECT images acquired before AD. Moreover, the mean thickness of the ascending, thoracic descending, and abdominal aortic walls before AD was defined as the non-dissection-related wall thickness (non-D-T). In the control group, the aortic wall thickness was measured similarly and defined as the control wall thickness (C-T). The D-T, non-D-T, and C-T values were compared using one-way analysis of variance with the Games-Howell pairwise comparison test. Results: The D-T (2.17±0.75 mm) was significantly greater than the non-D-T (1.58±0.22 mm; P<.01) and C-T (1.53±0.15 mm; P<.01). Conclusion: The aortic wall may have become thicker prior to the onset of AD.
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Affiliation(s)
- Hidemasa Saito
- Department of Radiology, Nippon Medical School, Tokyo, Japan
| | | | - Tatsuo Ueda
- Department of Radiology, Nippon Medical School, Tokyo, Japan
| | - Takahiko Mine
- Department of Radiology, Nippon Medical School, Tokyo, Japan
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Saito H, Tani Y, Ozaki A, Sawano T, Shimada Y, Yamamoto K, Tanimoto T. Financial ties between authors of the clinical practice guidelines and pharmaceutical companies: an example from Japan. Clin Microbiol Infect 2019; 25:1304-1306. [PMID: 31401175 DOI: 10.1016/j.cmi.2019.07.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 07/20/2019] [Accepted: 07/25/2019] [Indexed: 10/26/2022]
Affiliation(s)
- H Saito
- Department of Gastroenterology, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
| | - Y Tani
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - A Ozaki
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan; Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki, Fukushima, Japan
| | - T Sawano
- Department of Surgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - Y Shimada
- Department of Neurosurgery, Minamisoma Municipal General Hospital, Minamisoma, Fukushima, Japan
| | - K Yamamoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
| | - T Tanimoto
- Medical Governance Research Institute, Minato-ku, Tokyo, Japan
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Saito H, Nakakita Y, Segawa S, Tsuchiya Y. Oral administration of heat-killed Lactobacillus brevis SBC8803 elevates the ratio of acyl/des-acyl ghrelin in blood and increases short-term food intake. Benef Microbes 2019; 10:671-677. [DOI: 10.3920/bm2018.0091] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
It is known that gastrointestinal microbiota, probiotics and heat-killed microbes can regulate intestinal immunity; however, their effect on the secretion of gastrointestinal hormones is unclear. The secretion of gastrointestinal hormones can be mediated by the elevation of intracellular Ca2+ concentration, suggesting that these hormones may act through common mechanisms. We have previously shown that heat-killed Lactobacillus brevis SBC8803 (hk-SBC8803) induced the secretion of serotonin and elevated intracellular Ca2+ concentration in serotonin-producing RIN-14B cells, suggesting that hk-SBC8803 could potentially cause the same effect on other gastrointestinal hormones, including hunger hormone ghrelin. Here, we tested this hypothesis by treating cultured cells and experimental animals with hk-SBC8803 and assessing ghrelin secretion, expression of ghrelin-related genes, and food intake. The results indicated that hk-SBC8803 treatment for 30 min significantly upregulated the secretion of acyl ghrelin (active form) (P=0.046) and mRNA expression of the Syt3 (synaptotagmin 3) gene related to ghrelin exocytosis (P<0.05) in primary mouse stomach cells. In addition, oral administration of 500 mg/kg hk-SBC8803 to rats tended to upregulate acyl ghrelin concentration (P=0.10) and significantly increased the ratio of acyl to des-acyl (inactive) ghrelin (P=0.027) in blood, which corresponded to a tendency of stimulating food intake (P=0.087) at 30 min post-treatment. However, when in order to minimise individual differences we normalised the data on food intake to those on one-day food intake prior to food deprivation, the resultant food intake ratio showed a significant increase (by 5% compared to control; P=0.032) at 30 min after hk-SBC8803 treatment, indicating that hk-SBC8803 administration stimulated rats to take more food during the first meal after fasting. These results suggest that hk-SBC8803 induces short-term ghrelin secretion and transiently increases appetite, which is an important effect for individuals with low energy intake.
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Affiliation(s)
- H. Saito
- Frontier Laboratories for Value Creation, Sapporo Holdings Ltd., 10 Okatome, Yaizu, Shizuoka 425-0013, Japan
| | - Y. Nakakita
- Frontier Laboratories for Value Creation, Sapporo Holdings Ltd., 10 Okatome, Yaizu, Shizuoka 425-0013, Japan
| | - S. Segawa
- Frontier Laboratories for Value Creation, Sapporo Holdings Ltd., 10 Okatome, Yaizu, Shizuoka 425-0013, Japan
| | - Y. Tsuchiya
- Frontier Laboratories for Value Creation, Sapporo Holdings Ltd., 10 Okatome, Yaizu, Shizuoka 425-0013, Japan
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Hou H, Fujino R, Matsushita K, Unoki J, Gunda N, Jono H, Saito H. SAT-134 Sulfotransferase (Sult) 1a1 plays a toxico-pathological role in cisplatin-induced acute kidney injury (AKI) through metabolic generation of indoxyl sulfate (IS). Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.164] [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: 10/26/2022] Open
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Okuda K, Nakajima K, Saito H, Ito T, Kikuchi A, Yoneyama H, Shibutani T, Onoguchi M, Matsuo S, Hashimoto M, Kinuya S. P126Texture analysis of myocardial perfusion SPECT with a digital cardiac phantom. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez147.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Okuda
- Kanazawa Medical University, Physics, Ishikawa, Japan
| | - K Nakajima
- Kanazawa University Hospital, Nuclear Medicine, Kanazawa, Japan
| | - H Saito
- Kanazawa Medical University, Ishikawa, Japan
| | - T Ito
- Saiseikai Yokohamashi Tobu Hospital, Radiology, Yokohama, Japan
| | - A Kikuchi
- Hokkaido University of Science, Radiological Technology, Sapporo, Japan
| | - H Yoneyama
- Kanazawa University Hospital, Radiological Technology, Kanazawa, Japan
| | - T Shibutani
- Kanazawa University, Quantum Medical Technology, Kanazawa, Japan
| | - M Onoguchi
- Kanazawa University, Quantum Medical Technology, Kanazawa, Japan
| | - S Matsuo
- Kanazawa University Hospital, Nuclear Medicine, Kanazawa, Japan
| | - M Hashimoto
- Kanazawa Medical University, Physics, Ishikawa, Japan
| | - S Kinuya
- Kanazawa University Hospital, Nuclear Medicine, Kanazawa, Japan
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Saito H, Shibayama H, Miyoshi H, Toda J, Kusakabe S, Ichii M, Fujita J, Fukushima K, Yokota T, Maeda T, Mizuki M, Oritani K, Seto M, Ohshima K, Kanakura Y. THE INFLUENCE OF TUMOR IMMUNE MICROENVIRONMENT AND TUMOR IMMUNITY ON THE PATHOGENESIS, TREATMENT AND PROGNOSIS OF POST-TRANSPLANT LYMPHOPROLIFERATIVE DISORDERS (PTLD). Hematol Oncol 2019. [DOI: 10.1002/hon.15_2630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- H. Saito
- Department of Hematology and Oncology; Osaka University Graduate School of Medicine; Osaka Japan
| | - H. Shibayama
- Department of Hematology and Oncology; Osaka University Graduate School of Medicine; Osaka Japan
| | - H. Miyoshi
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
| | - J. Toda
- Department of Hematology and Oncology; Osaka University Graduate School of Medicine; Osaka Japan
| | - S. Kusakabe
- Department of Hematology and Oncology; Osaka University Graduate School of Medicine; Osaka Japan
| | - M. Ichii
- Department of Hematology and Oncology; Osaka University Graduate School of Medicine; Osaka Japan
| | - J. Fujita
- Department of Hematology and Oncology; Osaka University Graduate School of Medicine; Osaka Japan
| | - K. Fukushima
- Department of Hematology and Oncology; Osaka University Graduate School of Medicine; Osaka Japan
| | - T. Yokota
- Department of Hematology and Oncology; Osaka University Graduate School of Medicine; Osaka Japan
| | - T. Maeda
- Department of Hematology and Oncology; Osaka University Graduate School of Medicine; Osaka Japan
| | - M. Mizuki
- Department of Hematology and Oncology; Osaka University Graduate School of Medicine; Osaka Japan
| | - K. Oritani
- Department of Hematology; International University of Health and Welfare; Narita Japan
| | - M. Seto
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
| | - K. Ohshima
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
| | - Y. Kanakura
- Department of Hematology and Oncology; Osaka University Graduate School of Medicine; Osaka Japan
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Kouketsu A, Sato I, Oikawa M, Shimizu Y, Saito H, Tashiro K, Yamashita Y, Takahashi T, Kumamoto H. Regulatory T cells and M2-polarized tumour-associated macrophages are associated with the oncogenesis and progression of oral squamous cell carcinoma. Int J Oral Maxillofac Surg 2019; 48:1279-1288. [PMID: 31053518 DOI: 10.1016/j.ijom.2019.04.004] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 02/09/2019] [Accepted: 04/04/2019] [Indexed: 12/12/2022]
Abstract
Regulatory T cells (Tregs) and tumour-associated macrophages (TAMs) contribute to the tumour microenvironment by inhibiting anti-tumour immune responses. This study was performed to investigate the roles of Tregs and TAMs in oral squamous cell carcinoma (OSCC) and oral epithelial precursor lesions (OEPL). The expression of Treg markers CD25 and FoxP3 and TAM markers CD163 and CD204 was investigated in 82 OSCC and 45 OEPL specimens, and their associations with clinicopathological parameters were analyzed. Correlations were found among CD25, FoxP3, CD163, and CD204 levels (P < 0.001), and these targets were up-regulated in OSCC compared to OEPL (P < 0.001). In OSCC, infiltration of Tregs and/or M2 TAMs was associated with sex and clinicopathological features, such as tumour size, nodal metastasis, tissue differentiation, stromal reaction, invasive behaviour, and invasive depth. In OEPL, CD25, FoxP3, CD163, and CD204 immunoreactivities were significantly associated with sex, postoperative recurrence, and cancerization to OSCC. This study is novel in showing that the infiltration of Tregs and M2 TAMs is significantly associated with the progression of premalignant lesions to OSCC. This suggests that these cells represent prognostic biomarkers for premalignant lesion progression and that immunotherapeutic approaches to control Treg/M2 TAM numbers could protect against progression to malignancy.
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Affiliation(s)
- A Kouketsu
- Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan; Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan.
| | - I Sato
- Department of Pathology, Miyagi Cancer Centre, Natori, Miyagi, Japan
| | - M Oikawa
- Division of Oral Pathology, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Y Shimizu
- Division of Oral Pathology, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - H Saito
- Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - K Tashiro
- Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - Y Yamashita
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - T Takahashi
- Division of Oral and Maxillofacial Surgery, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
| | - H Kumamoto
- Division of Oral Pathology, Department of Oral Medicine and Surgery, Tohoku University Graduate School of Dentistry, Sendai, Miyagi, Japan
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Steele A, Mori S, Balasuriya B, Starr M, Saito H. CHRONIC MUSCLE WEAKNESS IS ACCOMPANIED BY PROLONGED OXIDATIVE DAMAGE IN MURINE SEPSIS SURVIVORS. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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