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Moritsubo M, Furuta T, Negoto T, Nakamura H, Uchiyama Y, Morioka M, Oshima K, Sugita Y. A case of a pilocytic astrocytoma with histological features of anaplasia and unprecedent genetic alterations. Neuropathology 2024; 44:161-166. [PMID: 37779355 DOI: 10.1111/neup.12946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 09/07/2023] [Accepted: 09/18/2023] [Indexed: 10/03/2023]
Abstract
We report a case of pediatric glioma with uncommon imaging, morphological, and genetic features. A one-year-old boy incidentally presented with a tumor in the fourth ventricle. The tumor was completely resected surgically and investigated pathologically. The mostly circumscribed tumor had piloid features but primitive and anaplastic histology, such as increasing cellularity and mitosis. The Ki-67 staining index was 25% at the hotspot. KIAA1549::BRAF fusion and KIAA1549 partial deletions were detected by direct PCR, supported by Sanger sequencing. To the best of our knowledge, this is the first report of a glioma with both deletion of KIAA1549 p.P1771_P1899 and fusion of KIAA1549::BRAF. The tumor could not be classified using DNA methylome analysis. The present tumor fell into the category of pilocytic astrocytoma with histological features of anaplasia (aPA). Further studies are needed to establish pediatric aPA.
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Affiliation(s)
- Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Tetsuya Negoto
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Hideo Nakamura
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Yusuke Uchiyama
- Department of Radiology, Kurume University School of Medicine, Kurume, Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Koichi Oshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Yasuo Sugita
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
- Department of Neuropathology, St. Mary's Hospital, Kurume, Japan
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Nagahata K, Osanami A, Nakamura H, Amaike H, Kanda M, Takahashi H. IgG4-related tubulointerstitial nephritis: renal capsule-like rim. QJM 2023; 116:953-954. [PMID: 37369024 DOI: 10.1093/qjmed/hcad157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Indexed: 06/29/2023] Open
Affiliation(s)
- K Nagahata
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, South West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan
| | - A Osanami
- Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, South-1, West-16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan
| | - H Nakamura
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, South West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan
| | - H Amaike
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, South West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan
| | - M Kanda
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, South West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan
| | - H Takahashi
- Department of Rheumatology and Clinical Immunology, Sapporo Medical University School of Medicine, South West 16, Chuo-ku, Sapporo, Hokkaido 060-8543, Japan
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Sakata K, Komaki S, Takeshige N, Negoto T, Kikuchi J, Kajiwara S, Orito K, Nakamura H, Hirohata M, Morioka M. Visual Outcomes and Surgical Approach Selection Focusing on Active Optic Canal Decompression and Maximum Safe Resection for Suprasellar Meningiomas. Neurol Med Chir (Tokyo) 2023; 63:381-392. [PMID: 37423756 PMCID: PMC10556211 DOI: 10.2176/jns-nmc.2021-0142] [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: 05/05/2021] [Accepted: 04/17/2023] [Indexed: 07/11/2023] Open
Abstract
The goal of treating patients with suprasellar meningioma is improving or preserving visual function while achieving long-term tumor control. We retrospectively examined patient and tumor characteristics and surgical and visual outcomes in 30 patients with a suprasellar meningioma who underwent resection via an endoscopic endonasal (15 patients), sub-frontal (8 patients), or anterior interhemispheric (7 patients) approach. Approach selection was based on the presence of optic canal invasion, vascular encasement, and tumor extension. Optic canal decompression and exploration were performed as key surgical procedures. Simpson grade 1 to 3 resection was achieved in 80% of cases. Among the 26 patients with pre-existing visual dysfunction, vision at discharge improved in 18 patients (69.2%), remained unchanged in six (23.1%), and deteriorated in two (7.7%). Further gradual visual recovery and/or maintenance of useful vision were also observed during follow-up. We propose an algorithm for selecting the appropriate surgical approach to a suprasellar meningioma based on preoperative radiologic tumor characteristics. The algorithm focuses on effective optic canal decompression and maximum safe resection, possibly contributing to favorable visual outcomes.
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Affiliation(s)
- Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine
| | - Satoru Komaki
- Department of Neurosurgery, Kurume University School of Medicine
| | | | - Tetsuya Negoto
- Department of Neurosurgery, Kurume University School of Medicine
| | - Jin Kikuchi
- Department of Neurosurgery, Kurume University School of Medicine
| | - Sosho Kajiwara
- Department of Neurosurgery, Kurume University School of Medicine
| | - Kimihiko Orito
- Department of Neurosurgery, Kurume University School of Medicine
| | - Hideo Nakamura
- Department of Neurosurgery, Kurume University School of Medicine
| | - Masaru Hirohata
- Department of Neurosurgery, Kurume University School of Medicine
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine
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Abe K, Akhlaq N, Akutsu R, Ali A, Alonso Monsalve S, Alt C, Andreopoulos C, Antonova M, Aoki S, Arihara T, Asada Y, Ashida Y, Atkin ET, Barbi M, Barker GJ, Barr G, Barrow D, Batkiewicz-Kwasniak M, Bench F, Berardi V, Berns L, Bhadra S, Blanchet A, Blondel A, Bolognesi S, Bonus T, Bordoni S, Boyd SB, Bravar A, Bronner C, Bron S, Bubak A, Buizza Avanzini M, Caballero JA, Calabria NF, Cao S, Carabadjac D, Carter AJ, Cartwright SL, Catanesi MG, Cervera A, Chakrani J, Cherdack D, Chong PS, Christodoulou G, Chvirova A, Cicerchia M, Coleman J, Collazuol G, Cook L, Cudd A, Dalmazzone C, Daret T, Davydov YI, De Roeck A, De Rosa G, Dealtry T, Delogu CC, Densham C, Dergacheva A, Di Lodovico F, Dolan S, Douqa D, Doyle TA, Drapier O, Dumarchez J, Dunne P, Dygnarowicz K, Eguchi A, Emery-Schrenk S, Erofeev G, Ershova A, Eurin G, Fedorova D, Fedotov S, Feltre M, Finch AJ, Fiorentini Aguirre GA, Fiorillo G, Fitton MD, Franco Patiño JM, Friend M, Fujii Y, Fukuda Y, Fusshoeller K, Giannessi L, Giganti C, Glagolev V, Gonin M, González Rosa J, Goodman EAG, Gorin A, Grassi M, Guigue M, Hadley DR, Haigh JT, Hamacher-Baumann P, Harris DA, Hartz M, Hasegawa T, Hassani S, Hastings NC, Hayato Y, Henaff D, Hiramoto A, Hogan M, Holeczek J, Holin A, Holvey T, Hong Van NT, Honjo T, Iacob F, Ichikawa AK, Ikeda M, Ishida T, Ishitsuka M, Israel HT, Iwamoto K, Izmaylov A, Izumi N, Jakkapu M, Jamieson B, Jenkins SJ, Jesús-Valls C, Jiang JJ, Jonsson P, Joshi S, Jung CK, Jurj PB, Kabirnezhad M, Kaboth AC, Kajita T, Kakuno H, Kameda J, Kasetti SP, Kataoka Y, Katayama Y, Katori T, Kawaue M, Kearns E, Khabibullin M, Khotjantsev A, Kikawa T, Kikutani H, King S, Kiseeva V, Kisiel J, Kobata T, Kobayashi H, Kobayashi T, Koch L, Kodama S, Konaka A, Kormos LL, Koshio Y, Kostin A, Koto T, Kowalik K, Kudenko Y, Kudo Y, Kuribayashi S, Kurjata R, Kutter T, Kuze M, La Commara M, Labarga L, Lachner K, Lagoda J, Lakshmi SM, Lamers James M, Lamoureux M, Langella A, Laporte JF, Last D, Latham N, Laveder M, Lavitola L, Lawe M, Lee Y, Lin C, Lin SK, Litchfield RP, Liu SL, Li W, Longhin A, Long KR, Lopez Moreno A, Ludovici L, Lu X, Lux T, Machado LN, Magaletti L, Mahn K, Malek M, Mandal M, Manly S, Marino AD, Marti-Magro L, Martin DGR, Martini M, Martin JF, Maruyama T, Matsubara T, Matveev V, Mauger C, Mavrokoridis K, Mazzucato E, McCauley N, McElwee J, McFarland KS, McGrew C, McKean J, Mefodiev A, Megias GD, Mehta P, Mellet L, Metelko C, Mezzetto M, Miller E, Minamino A, Mineev O, Mine S, Miura M, Molina Bueno L, Moriyama S, Moriyama S, Morrison P, Mueller TA, Munford D, Munteanu L, Nagai K, Nagai Y, Nakadaira T, Nakagiri K, Nakahata M, Nakajima Y, Nakamura A, Nakamura H, Nakamura K, Nakamura KD, Nakano Y, Nakayama S, Nakaya T, Nakayoshi K, Naseby CER, Ngoc TV, Nguyen VQ, Niewczas K, Nishimori S, Nishimura Y, Nishizaki K, Nosek T, Nova F, Novella P, Nugent JC, O’Keeffe HM, O’Sullivan L, Odagawa T, Ogawa T, Okada R, Okinaga W, Okumura K, Okusawa T, Ospina N, Owen RA, Oyama Y, Palladino V, Paolone V, Pari M, Parlone J, Parsa S, Pasternak J, Pavin M, Payne D, Penn GC, Pershey D, Pickering L, Pidcott C, Pintaudi G, Pistillo C, Popov B, Porwit K, Posiadala-Zezula M, Prabhu YS, Pupilli F, Quilain B, Radermacher T, Radicioni E, Radics B, Ramírez MA, Ratoff PN, Reh M, Riccio C, Rondio E, Roth S, Roy N, Rubbia A, Ruggeri AC, Ruggles CA, Rychter A, Sakashita K, Sánchez F, Santucci G, Schloesser CM, Scholberg K, Scott M, Seiya Y, Sekiguchi T, Sekiya H, Sgalaberna D, Shaikhiev A, Shaker F, Shaykina A, Shiozawa M, Shorrock W, Shvartsman A, Skrobova N, Skwarczynski K, Smyczek D, Smy M, Sobczyk JT, Sobel H, Soler FJP, Sonoda Y, Speers AJ, Spina R, Suslov IA, Suvorov S, Suzuki A, Suzuki SY, Suzuki Y, Sztuc AA, Tada M, Tairafune S, Takayasu S, Takeda A, Takeuchi Y, Takifuji K, Tanaka HK, Tanihara Y, Tani M, Teklu A, Tereshchenko VV, Teshima N, Thamm N, Thompson LF, Toki W, Touramanis C, Towstego T, Tsui KM, Tsukamoto T, Tzanov M, Uchida Y, Vagins M, Vargas D, Varghese M, Vasseur G, Vilela C, Villa E, Vinning WGS, Virginet U, Vladisavljevic T, Wachala T, Walsh JG, Wang Y, Wan L, Wark D, Wascko MO, Weber A, Wendell R, Wilking MJ, Wilkinson C, Wilson JR, Wood K, Wret C, Xia J, Xu YH, Yamamoto K, Yamamoto T, Yanagisawa C, Yang G, Yano T, Yasutome K, Yershov N, Yevarouskaya U, Yokoyama M, Yoshimoto Y, Yoshimura N, Yu M, Zaki R, Zalewska A, Zalipska J, Zaremba K, Zarnecki G, Zhao X, Zhu T, Ziembicki M, Zimmerman ED, Zito M, Zsoldos S. Measurements of neutrino oscillation parameters from the T2K experiment using 3.6×1021 protons on target. Eur Phys J C Part Fields 2023; 83:782. [PMID: 37680254 PMCID: PMC10480298 DOI: 10.1140/epjc/s10052-023-11819-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Accepted: 07/10/2023] [Indexed: 09/09/2023]
Abstract
The T2K experiment presents new measurements of neutrino oscillation parameters using 19.7 ( 16.3 ) × 10 20 protons on target (POT) in (anti-)neutrino mode at the far detector (FD). Compared to the previous analysis, an additional 4.7 × 10 20 POT neutrino data was collected at the FD. Significant improvements were made to the analysis methodology, with the near-detector analysis introducing new selections and using more than double the data. Additionally, this is the first T2K oscillation analysis to use NA61/SHINE data on a replica of the T2K target to tune the neutrino flux model, and the neutrino interaction model was improved to include new nuclear effects and calculations. Frequentist and Bayesian analyses are presented, including results on sin 2 θ 13 and the impact of priors on the δ CP measurement. Both analyses prefer the normal mass ordering and upper octant of sin 2 θ 23 with a nearly maximally CP-violating phase. Assuming the normal ordering and using the constraint on sin 2 θ 13 from reactors, sin 2 θ 23 = 0 . 561 - 0.032 + 0.021 using Feldman-Cousins corrected intervals, and Δ m 32 2 = 2 . 494 - 0.058 + 0.041 × 10 - 3 eV 2 using constant Δ χ 2 intervals. The CP-violating phase is constrained to δ CP = - 1 . 97 - 0.70 + 0.97 using Feldman-Cousins corrected intervals, and δ CP = 0 , π is excluded at more than 90% confidence level. A Jarlskog invariant of zero is excluded at more than 2 σ credible level using a flat prior in δ CP , and just below 2 σ using a flat prior in sin δ CP . When the external constraint on sin 2 θ 13 is removed, sin 2 θ 13 = 28 . 0 - 6.5 + 2.8 × 10 - 3 , in agreement with measurements from reactor experiments. These results are consistent with previous T2K analyses.
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Affiliation(s)
- K. Abe
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
| | - N. Akhlaq
- School of Physics and Astronomy, Queen Mary University of London, London, UK
| | - R. Akutsu
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
| | - A. Ali
- TRIUMF, Vancouver, BC Canada
- Department of Physics, University of Winnipeg, Winnipeg, MB Canada
| | - S. Alonso Monsalve
- Institute for Particle Physics and Astrophysics, ETH Zurich, Zurich, Switzerland
| | - C. Alt
- Institute for Particle Physics and Astrophysics, ETH Zurich, Zurich, Switzerland
| | - C. Andreopoulos
- Department of Physics, University of Liverpool, Liverpool, UK
| | - M. Antonova
- IFIC (CSIC and University of Valencia), Valencia, Spain
| | - S. Aoki
- Kobe University, Kobe, Japan
| | - T. Arihara
- Department of Physics, Tokyo Metropolitan University, Tokyo, Japan
| | - Y. Asada
- Department of Physics, Yokohama National University, Yokohama, Japan
| | - Y. Ashida
- Department of Physics, Kyoto University, Kyoto, Japan
| | - E. T. Atkin
- Department of Physics, Imperial College London, London, UK
| | - M. Barbi
- Department of Physics, University of Regina, Regina, Saskatchewan Canada
| | - G. J. Barker
- Department of Physics, University of Warwick, Coventry, UK
| | - G. Barr
- Department of Physics, Oxford University, Oxford, UK
| | - D. Barrow
- Department of Physics, Oxford University, Oxford, UK
| | | | - F. Bench
- Department of Physics, University of Liverpool, Liverpool, UK
| | - V. Berardi
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, Bari, Italy
| | - L. Berns
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi Japan
| | - S. Bhadra
- Department of Physics and Astronomy, York University, Toronto, ON Canada
| | - A. Blanchet
- Section de Physique, DPNC, University of Geneva, Geneva, Switzerland
| | - A. Blondel
- Section de Physique, DPNC, University of Geneva, Geneva, Switzerland
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Paris, France
| | - S. Bolognesi
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - T. Bonus
- Faculty of Physics and Astronomy, Wroclaw University, Wrocław, Poland
| | - S. Bordoni
- Section de Physique, DPNC, University of Geneva, Geneva, Switzerland
| | - S. B. Boyd
- Department of Physics, University of Warwick, Coventry, UK
| | - A. Bravar
- Section de Physique, DPNC, University of Geneva, Geneva, Switzerland
| | - C. Bronner
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
| | - S. Bron
- TRIUMF, Vancouver, BC Canada
| | - A. Bubak
- Institute of Physics, University of Silesia, Katowice, Poland
| | - M. Buizza Avanzini
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, IN2P3-CNRS, Palaiseau, France
| | - J. A. Caballero
- Departamento de Física Atómica, Molecular y Nuclear, Universidad de Sevilla, 41080 Sevilla, Spain
| | - N. F. Calabria
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, Bari, Italy
| | - S. Cao
- Institute For Interdisciplinary Research in Science and Education (IFIRSE), ICISE, Quy Nhon, Vietnam
| | - D. Carabadjac
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, IN2P3-CNRS, Palaiseau, France
- Université Paris-Saclay, Gif-sur-Yvette, France
| | - A. J. Carter
- Department of Physics, Royal Holloway University of London, Egham, Surrey UK
| | - S. L. Cartwright
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK
| | - M. G. Catanesi
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, Bari, Italy
| | - A. Cervera
- IFIC (CSIC and University of Valencia), Valencia, Spain
| | - J. Chakrani
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, IN2P3-CNRS, Palaiseau, France
| | - D. Cherdack
- Department of Physics, University of Houston, Houston, TX USA
| | - P. S. Chong
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - G. Christodoulou
- CERN European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - A. Chvirova
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M. Cicerchia
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, Padua, Italy
- INFN-Laboratori Nazionali di Legnaro, Legnaro, Italy
| | - J. Coleman
- Department of Physics, University of Liverpool, Liverpool, UK
| | - G. Collazuol
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, Padua, Italy
| | - L. Cook
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
- Department of Physics, Oxford University, Oxford, UK
| | - A. Cudd
- Department of Physics, University of Colorado at Boulder, Boulder, CO USA
| | - C. Dalmazzone
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Paris, France
| | - T. Daret
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - Yu. I. Davydov
- Joint Institute for Nuclear Research, Dubna, Moscow Region Russia
| | - A. De Roeck
- CERN European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - G. De Rosa
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, Naples, Italy
| | - T. Dealtry
- Physics Department, Lancaster University, Lancaster, UK
| | - C. C. Delogu
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, Padua, Italy
| | - C. Densham
- Rutherford Appleton Laboratory, STFC, Harwell, Oxford, UK
- Department of Physics, University of Tokyo, Tokyo, Japan
| | - A. Dergacheva
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - F. Di Lodovico
- Department of Physics, King’s College London, Strand, London, WC2R 2LS UK
| | - S. Dolan
- CERN European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - D. Douqa
- Section de Physique, DPNC, University of Geneva, Geneva, Switzerland
| | - T. A. Doyle
- Department of Physics and Astronomy, State University of New York at Stony Brook, Stony Brook, NY USA
| | - O. Drapier
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, IN2P3-CNRS, Palaiseau, France
| | - J. Dumarchez
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Paris, France
| | - P. Dunne
- Department of Physics, Imperial College London, London, UK
| | - K. Dygnarowicz
- Institute of Radioelectronics and Multimedia Technology, Warsaw University of Technology, Warsaw, Poland
| | - A. Eguchi
- Department of Physics, University of Tokyo, Tokyo, Japan
| | - S. Emery-Schrenk
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - G. Erofeev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - A. Ershova
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - G. Eurin
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - D. Fedorova
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - S. Fedotov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M. Feltre
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, Padua, Italy
| | - A. J. Finch
- Physics Department, Lancaster University, Lancaster, UK
| | | | - G. Fiorillo
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, Naples, Italy
| | - M. D. Fitton
- Rutherford Appleton Laboratory, STFC, Harwell, Oxford, UK
| | - J. M. Franco Patiño
- Departamento de Física Atómica, Molecular y Nuclear, Universidad de Sevilla, 41080 Sevilla, Spain
| | - M. Friend
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- J-PARC, Tokai, Japan
| | - Y. Fujii
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- J-PARC, Tokai, Japan
| | - Y. Fukuda
- Department of Physics, Miyagi University of Education, Sendai, Japan
| | - K. Fusshoeller
- Institute for Particle Physics and Astrophysics, ETH Zurich, Zurich, Switzerland
| | - L. Giannessi
- Section de Physique, DPNC, University of Geneva, Geneva, Switzerland
| | - C. Giganti
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Paris, France
| | - V. Glagolev
- Joint Institute for Nuclear Research, Dubna, Moscow Region Russia
| | - M. Gonin
- ILANCE, CNRS-University of Tokyo International Research Laboratory, Kashiwa, Chiba 277-8582 Japan
| | - J. González Rosa
- Departamento de Física Atómica, Molecular y Nuclear, Universidad de Sevilla, 41080 Sevilla, Spain
| | - E. A. G. Goodman
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK
| | - A. Gorin
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M. Grassi
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, Padua, Italy
| | - M. Guigue
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Paris, France
| | - D. R. Hadley
- Department of Physics, University of Warwick, Coventry, UK
| | - J. T. Haigh
- Department of Physics, University of Warwick, Coventry, UK
| | | | - D. A. Harris
- Department of Physics and Astronomy, York University, Toronto, ON Canada
| | - M. Hartz
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
- TRIUMF, Vancouver, BC Canada
| | - T. Hasegawa
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- J-PARC, Tokai, Japan
| | - S. Hassani
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - N. C. Hastings
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
| | - Y. Hayato
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
| | - D. Henaff
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - A. Hiramoto
- Department of Physics, Kyoto University, Kyoto, Japan
| | - M. Hogan
- Department of Physics, Colorado State University, Fort Collins, Colorado USA
| | - J. Holeczek
- Institute of Physics, University of Silesia, Katowice, Poland
| | - A. Holin
- Rutherford Appleton Laboratory, STFC, Harwell, Oxford, UK
| | - T. Holvey
- Department of Physics, Oxford University, Oxford, UK
| | - N. T. Hong Van
- International Centre of Physics, Institute of Physics (IOP), Vietnam Academy of Science and Technology (VAST), 10 Dao Tan, Ba Dinh, Hanoi, Vietnam
| | - T. Honjo
- Department of Physics, Osaka Metropolitan University, Osaka, Japan
| | - F. Iacob
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, Padua, Italy
| | - A. K. Ichikawa
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi Japan
| | - M. Ikeda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
| | - T. Ishida
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- J-PARC, Tokai, Japan
| | - M. Ishitsuka
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba Japan
| | - H. T. Israel
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK
| | - K. Iwamoto
- Department of Physics, University of Tokyo, Tokyo, Japan
| | - A. Izmaylov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - N. Izumi
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba Japan
| | - M. Jakkapu
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
| | - B. Jamieson
- Department of Physics, University of Winnipeg, Winnipeg, MB Canada
| | - S. J. Jenkins
- Department of Physics, University of Liverpool, Liverpool, UK
| | - C. Jesús-Valls
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
| | - J. J. Jiang
- Department of Physics and Astronomy, State University of New York at Stony Brook, Stony Brook, NY USA
| | - P. Jonsson
- Department of Physics, Imperial College London, London, UK
| | - S. Joshi
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - C. K. Jung
- Department of Physics and Astronomy, State University of New York at Stony Brook, Stony Brook, NY USA
- Kavli IPMU (WPI), The University of Tokyo, Tokyo, Japan
| | - P. B. Jurj
- Department of Physics, Imperial College London, London, UK
| | - M. Kabirnezhad
- Department of Physics, Imperial College London, London, UK
| | - A. C. Kaboth
- Department of Physics, Royal Holloway University of London, Egham, Surrey UK
- Rutherford Appleton Laboratory, STFC, Harwell, Oxford, UK
| | - T. Kajita
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Japan
- Kavli IPMU (WPI), The University of Tokyo, Tokyo, Japan
| | - H. Kakuno
- Department of Physics, Tokyo Metropolitan University, Tokyo, Japan
| | - J. Kameda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
| | - S. P. Kasetti
- Department of Physics and Astronomy, Louisiana State University, Baton Rouge, LA USA
| | - Y. Kataoka
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
| | - Y. Katayama
- Department of Physics, Yokohama National University, Yokohama, Japan
| | - T. Katori
- Department of Physics, King’s College London, Strand, London, WC2R 2LS UK
| | - M. Kawaue
- Department of Physics, Kyoto University, Kyoto, Japan
| | - E. Kearns
- Department of Physics, Boston University, Boston, MA USA
- Kavli IPMU (WPI), The University of Tokyo, Tokyo, Japan
| | - M. Khabibullin
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - A. Khotjantsev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - T. Kikawa
- Department of Physics, Kyoto University, Kyoto, Japan
| | - H. Kikutani
- Department of Physics, University of Tokyo, Tokyo, Japan
| | - S. King
- Department of Physics, King’s College London, Strand, London, WC2R 2LS UK
| | - V. Kiseeva
- Joint Institute for Nuclear Research, Dubna, Moscow Region Russia
| | - J. Kisiel
- Institute of Physics, University of Silesia, Katowice, Poland
| | - T. Kobata
- Department of Physics, Osaka Metropolitan University, Osaka, Japan
| | - H. Kobayashi
- Department of Physics, University of Tokyo, Tokyo, Japan
| | - T. Kobayashi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- J-PARC, Tokai, Japan
| | - L. Koch
- Institut für Physik, Johannes Gutenberg-Universität Mainz, Staudingerweg 7, 55128 Mainz, Germany
| | - S. Kodama
- Department of Physics, University of Tokyo, Tokyo, Japan
| | | | - L. L. Kormos
- Physics Department, Lancaster University, Lancaster, UK
| | - Y. Koshio
- Department of Physics, Okayama University, Okayama, Japan
- Kavli IPMU (WPI), The University of Tokyo, Tokyo, Japan
| | - A. Kostin
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - T. Koto
- Department of Physics, Tokyo Metropolitan University, Tokyo, Japan
| | - K. Kowalik
- National Centre for Nuclear Research, Warsaw, Poland
| | - Y. Kudenko
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
- Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia and National Research Nuclear University “MEPhI”, Moscow, Russia
| | - Y. Kudo
- Department of Physics, Yokohama National University, Yokohama, Japan
| | | | - R. Kurjata
- Institute of Radioelectronics and Multimedia Technology, Warsaw University of Technology, Warsaw, Poland
| | - T. Kutter
- Department of Physics and Astronomy, Louisiana State University, Baton Rouge, LA USA
| | - M. Kuze
- Department of Physics, Tokyo Institute of Technology, Tokyo, Japan
| | - M. La Commara
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, Naples, Italy
| | - L. Labarga
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
| | - K. Lachner
- Department of Physics, University of Warwick, Coventry, UK
| | - J. Lagoda
- National Centre for Nuclear Research, Warsaw, Poland
| | - S. M. Lakshmi
- National Centre for Nuclear Research, Warsaw, Poland
| | - M. Lamers James
- Physics Department, Lancaster University, Lancaster, UK
- Rutherford Appleton Laboratory, STFC, Harwell, Oxford, UK
| | - M. Lamoureux
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, Padua, Italy
| | - A. Langella
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, Naples, Italy
| | - J.-F. Laporte
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - D. Last
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - N. Latham
- Department of Physics, University of Warwick, Coventry, UK
| | - M. Laveder
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, Padua, Italy
| | - L. Lavitola
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, Naples, Italy
| | - M. Lawe
- Physics Department, Lancaster University, Lancaster, UK
| | - Y. Lee
- Department of Physics, Kyoto University, Kyoto, Japan
| | - C. Lin
- Department of Physics, Imperial College London, London, UK
| | - S.-K. Lin
- Department of Physics and Astronomy, Louisiana State University, Baton Rouge, LA USA
| | - R. P. Litchfield
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK
| | - S. L. Liu
- Department of Physics and Astronomy, State University of New York at Stony Brook, Stony Brook, NY USA
| | - W. Li
- Department of Physics, Oxford University, Oxford, UK
| | - A. Longhin
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, Padua, Italy
| | - K. R. Long
- Department of Physics, Imperial College London, London, UK
- Rutherford Appleton Laboratory, STFC, Harwell, Oxford, UK
| | - A. Lopez Moreno
- Department of Physics, King’s College London, Strand, London, WC2R 2LS UK
| | - L. Ludovici
- INFN Sezione di Roma and Università di Roma “La Sapienza”, Rome, Italy
| | - X. Lu
- Department of Physics, University of Warwick, Coventry, UK
| | - T. Lux
- Institut de Fisica d’Altes Energies (IFAE)-The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, Barcelona Spain
| | - L. N. Machado
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK
| | - L. Magaletti
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, Bari, Italy
| | - K. Mahn
- Department of Physics and Astronomy, Michigan State University, East Lansing, MI USA
| | - M. Malek
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK
| | - M. Mandal
- National Centre for Nuclear Research, Warsaw, Poland
| | - S. Manly
- Department of Physics and Astronomy, University of Rochester, Rochester, NY USA
| | - A. D. Marino
- Department of Physics, University of Colorado at Boulder, Boulder, CO USA
| | - L. Marti-Magro
- Department of Physics, Yokohama National University, Yokohama, Japan
| | | | - M. Martini
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Paris, France
- IPSA-DRII, Ivry-sur-Seine, France
| | - J. F. Martin
- Department of Physics, University of Toronto, Toronto, ON Canada
| | - T. Maruyama
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- J-PARC, Tokai, Japan
| | - T. Matsubara
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
| | - V. Matveev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - C. Mauger
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - K. Mavrokoridis
- Department of Physics, University of Liverpool, Liverpool, UK
| | - E. Mazzucato
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - N. McCauley
- Department of Physics, University of Liverpool, Liverpool, UK
| | - J. McElwee
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK
| | - K. S. McFarland
- Department of Physics and Astronomy, University of Rochester, Rochester, NY USA
| | - C. McGrew
- Department of Physics and Astronomy, State University of New York at Stony Brook, Stony Brook, NY USA
| | - J. McKean
- Department of Physics, Imperial College London, London, UK
| | - A. Mefodiev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - G. D. Megias
- Departamento de Física Atómica, Molecular y Nuclear, Universidad de Sevilla, 41080 Sevilla, Spain
| | - P. Mehta
- Department of Physics, University of Liverpool, Liverpool, UK
| | - L. Mellet
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Paris, France
| | - C. Metelko
- Department of Physics, University of Liverpool, Liverpool, UK
| | - M. Mezzetto
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, Padua, Italy
| | - E. Miller
- Department of Physics, King’s College London, Strand, London, WC2R 2LS UK
| | - A. Minamino
- Department of Physics, Yokohama National University, Yokohama, Japan
| | - O. Mineev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - S. Mine
- Department of Physics and Astronomy, University of California, Irvine, Irvine, CA USA
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
| | - M. Miura
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
- Kavli IPMU (WPI), The University of Tokyo, Tokyo, Japan
| | | | - S. Moriyama
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
- Kavli IPMU (WPI), The University of Tokyo, Tokyo, Japan
| | - S. Moriyama
- Department of Physics, Yokohama National University, Yokohama, Japan
- Kavli IPMU (WPI), The University of Tokyo, Tokyo, Japan
| | - P. Morrison
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK
| | - Th. A. Mueller
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, IN2P3-CNRS, Palaiseau, France
| | - D. Munford
- Department of Physics, University of Houston, Houston, TX USA
| | - L. Munteanu
- CERN European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - K. Nagai
- Department of Physics, Yokohama National University, Yokohama, Japan
| | - Y. Nagai
- Department of Atomic Physics, Eötvös Loránd University, Budapest, Hungary
| | - T. Nakadaira
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- J-PARC, Tokai, Japan
| | - K. Nakagiri
- Department of Physics, University of Tokyo, Tokyo, Japan
| | - M. Nakahata
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
| | - Y. Nakajima
- Department of Physics, University of Tokyo, Tokyo, Japan
| | - A. Nakamura
- Department of Physics, Okayama University, Okayama, Japan
| | - H. Nakamura
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba Japan
| | - K. Nakamura
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
- J-PARC, Tokai, Japan
| | - K. D. Nakamura
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi Japan
| | - Y. Nakano
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
| | - S. Nakayama
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
| | - T. Nakaya
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
- Department of Physics, Kyoto University, Kyoto, Japan
| | - K. Nakayoshi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- J-PARC, Tokai, Japan
| | | | - T. V. Ngoc
- Institute For Interdisciplinary Research in Science and Education (IFIRSE), ICISE, Quy Nhon, Vietnam
- The Graduate University of Science and Technology, Vietnam Academy of Science and Technology, Ho Chi Minh City, Vietnam
| | - V. Q. Nguyen
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, IN2P3-CNRS, Palaiseau, France
| | - K. Niewczas
- Faculty of Physics and Astronomy, Wroclaw University, Wrocław, Poland
| | - S. Nishimori
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
| | - Y. Nishimura
- Department of Physics, Keio University, Yokohama, Kanagawa Japan
| | - K. Nishizaki
- Department of Physics, Osaka Metropolitan University, Osaka, Japan
| | - T. Nosek
- National Centre for Nuclear Research, Warsaw, Poland
| | - F. Nova
- Rutherford Appleton Laboratory, STFC, Harwell, Oxford, UK
| | - P. Novella
- IFIC (CSIC and University of Valencia), Valencia, Spain
| | - J. C. Nugent
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi Japan
| | | | - L. O’Sullivan
- Institut für Physik, Johannes Gutenberg-Universität Mainz, Staudingerweg 7, 55128 Mainz, Germany
| | - T. Odagawa
- Department of Physics, Kyoto University, Kyoto, Japan
| | - T. Ogawa
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
| | - R. Okada
- Department of Physics, Okayama University, Okayama, Japan
| | - W. Okinaga
- Department of Physics, University of Tokyo, Tokyo, Japan
| | - K. Okumura
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Japan
| | - T. Okusawa
- Department of Physics, Osaka Metropolitan University, Osaka, Japan
| | - N. Ospina
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
| | - R. A. Owen
- School of Physics and Astronomy, Queen Mary University of London, London, UK
| | - Y. Oyama
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- J-PARC, Tokai, Japan
| | - V. Palladino
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, Naples, Italy
| | - V. Paolone
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, PA USA
| | - M. Pari
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, Padua, Italy
| | - J. Parlone
- Department of Physics, University of Liverpool, Liverpool, UK
| | - S. Parsa
- Section de Physique, DPNC, University of Geneva, Geneva, Switzerland
| | - J. Pasternak
- Department of Physics, Imperial College London, London, UK
| | | | - D. Payne
- Department of Physics, University of Liverpool, Liverpool, UK
| | - G. C. Penn
- Department of Physics, University of Liverpool, Liverpool, UK
| | - D. Pershey
- Department of Physics, Duke University, Durham, NC USA
| | - L. Pickering
- Department of Physics, Royal Holloway University of London, Egham, Surrey UK
| | - C. Pidcott
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK
| | - G. Pintaudi
- Department of Physics, Yokohama National University, Yokohama, Japan
| | - C. Pistillo
- Laboratory for High Energy Physics (LHEP), Albert Einstein Center for Fundamental Physics, University of Bern, Bern, Switzerland
| | - B. Popov
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Paris, France
- JINR, Dubna, Russia
| | - K. Porwit
- Institute of Physics, University of Silesia, Katowice, Poland
| | | | - Y. S. Prabhu
- National Centre for Nuclear Research, Warsaw, Poland
| | - F. Pupilli
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, Padua, Italy
| | - B. Quilain
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, IN2P3-CNRS, Palaiseau, France
| | - T. Radermacher
- III. Physikalisches Institut, RWTH Aachen University, Aachen, Germany
| | - E. Radicioni
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, Bari, Italy
| | - B. Radics
- Department of Physics and Astronomy, York University, Toronto, ON Canada
| | - M. A. Ramírez
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - P. N. Ratoff
- Physics Department, Lancaster University, Lancaster, UK
| | - M. Reh
- Department of Physics, University of Colorado at Boulder, Boulder, CO USA
| | - C. Riccio
- Department of Physics and Astronomy, State University of New York at Stony Brook, Stony Brook, NY USA
| | - E. Rondio
- National Centre for Nuclear Research, Warsaw, Poland
| | - S. Roth
- III. Physikalisches Institut, RWTH Aachen University, Aachen, Germany
| | - N. Roy
- Department of Physics and Astronomy, York University, Toronto, ON Canada
| | - A. Rubbia
- Institute for Particle Physics and Astrophysics, ETH Zurich, Zurich, Switzerland
| | - A. C. Ruggeri
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, Naples, Italy
| | - C. A. Ruggles
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK
| | - A. Rychter
- Institute of Radioelectronics and Multimedia Technology, Warsaw University of Technology, Warsaw, Poland
| | - K. Sakashita
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- J-PARC, Tokai, Japan
| | - F. Sánchez
- Section de Physique, DPNC, University of Geneva, Geneva, Switzerland
| | - G. Santucci
- Department of Physics and Astronomy, York University, Toronto, ON Canada
| | - C. M. Schloesser
- Section de Physique, DPNC, University of Geneva, Geneva, Switzerland
| | - K. Scholberg
- Department of Physics, Duke University, Durham, NC USA
- Kavli IPMU (WPI), The University of Tokyo, Tokyo, Japan
| | - M. Scott
- Department of Physics, Imperial College London, London, UK
| | - Y. Seiya
- Department of Physics, Osaka Metropolitan University, Osaka, Japan
- Science Department, BMCC/CUNY, New York, NY USA
| | - T. Sekiguchi
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- J-PARC, Tokai, Japan
| | - H. Sekiya
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
- Kavli IPMU (WPI), The University of Tokyo, Tokyo, Japan
| | - D. Sgalaberna
- Institute for Particle Physics and Astrophysics, ETH Zurich, Zurich, Switzerland
| | - A. Shaikhiev
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - F. Shaker
- Department of Physics and Astronomy, York University, Toronto, ON Canada
| | - A. Shaykina
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - M. Shiozawa
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
| | - W. Shorrock
- Department of Physics, Imperial College London, London, UK
| | - A. Shvartsman
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - N. Skrobova
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | | | - D. Smyczek
- III. Physikalisches Institut, RWTH Aachen University, Aachen, Germany
| | - M. Smy
- Department of Physics and Astronomy, University of California, Irvine, Irvine, CA USA
| | - J. T. Sobczyk
- Faculty of Physics and Astronomy, Wroclaw University, Wrocław, Poland
| | - H. Sobel
- Department of Physics and Astronomy, University of California, Irvine, Irvine, CA USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
| | - F. J. P. Soler
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK
| | - Y. Sonoda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
| | - A. J. Speers
- Physics Department, Lancaster University, Lancaster, UK
| | - R. Spina
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, Bari, Italy
| | - I. A. Suslov
- Joint Institute for Nuclear Research, Dubna, Moscow Region Russia
| | - S. Suvorov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Paris, France
| | | | - S. Y. Suzuki
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- J-PARC, Tokai, Japan
| | - Y. Suzuki
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
| | - A. A. Sztuc
- Department of Physics, Imperial College London, London, UK
| | - M. Tada
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- J-PARC, Tokai, Japan
| | - S. Tairafune
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi Japan
| | - S. Takayasu
- Department of Physics, Osaka Metropolitan University, Osaka, Japan
| | - A. Takeda
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
| | - Y. Takeuchi
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
- Kobe University, Kobe, Japan
| | - K. Takifuji
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi Japan
| | - H. K. Tanaka
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
- Kavli IPMU (WPI), The University of Tokyo, Tokyo, Japan
| | - Y. Tanihara
- Department of Physics, Yokohama National University, Yokohama, Japan
| | - M. Tani
- Department of Physics, Kyoto University, Kyoto, Japan
| | - A. Teklu
- Department of Physics and Astronomy, State University of New York at Stony Brook, Stony Brook, NY USA
| | | | - N. Teshima
- Department of Physics, Osaka Metropolitan University, Osaka, Japan
| | - N. Thamm
- III. Physikalisches Institut, RWTH Aachen University, Aachen, Germany
| | - L. F. Thompson
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK
| | - W. Toki
- Department of Physics, Colorado State University, Fort Collins, Colorado USA
| | - C. Touramanis
- Department of Physics, University of Liverpool, Liverpool, UK
| | - T. Towstego
- Department of Physics, University of Toronto, Toronto, ON Canada
| | - K. M. Tsui
- Department of Physics, University of Liverpool, Liverpool, UK
| | - T. Tsukamoto
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- J-PARC, Tokai, Japan
| | - M. Tzanov
- Department of Physics and Astronomy, Louisiana State University, Baton Rouge, LA USA
| | - Y. Uchida
- Department of Physics, Imperial College London, London, UK
| | - M. Vagins
- Department of Physics and Astronomy, University of California, Irvine, Irvine, CA USA
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
| | - D. Vargas
- Institut de Fisica d’Altes Energies (IFAE)-The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, Barcelona Spain
| | - M. Varghese
- Institut de Fisica d’Altes Energies (IFAE)-The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, Barcelona Spain
| | - G. Vasseur
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
| | - C. Vilela
- CERN European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - E. Villa
- CERN European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
- Section de Physique, DPNC, University of Geneva, Geneva, Switzerland
| | | | - U. Virginet
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Paris, France
| | | | - T. Wachala
- H. Niewodniczanski Institute of Nuclear Physics PAN, Cracow, Poland
| | - J. G. Walsh
- Department of Physics and Astronomy, Michigan State University, East Lansing, MI USA
| | - Y. Wang
- Department of Physics and Astronomy, State University of New York at Stony Brook, Stony Brook, NY USA
| | - L. Wan
- Department of Physics, Boston University, Boston, MA USA
| | - D. Wark
- Department of Physics, Oxford University, Oxford, UK
- Rutherford Appleton Laboratory, STFC, Harwell, Oxford, UK
| | - M. O. Wascko
- Department of Physics, Imperial College London, London, UK
| | - A. Weber
- Institut für Physik, Johannes Gutenberg-Universität Mainz, Staudingerweg 7, 55128 Mainz, Germany
| | - R. Wendell
- Department of Physics, Kyoto University, Kyoto, Japan
- Kavli IPMU (WPI), The University of Tokyo, Tokyo, Japan
| | - M. J. Wilking
- Department of Physics and Astronomy, State University of New York at Stony Brook, Stony Brook, NY USA
| | - C. Wilkinson
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720 USA
| | - J. R. Wilson
- Department of Physics, King’s College London, Strand, London, WC2R 2LS UK
| | - K. Wood
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720 USA
| | - C. Wret
- Department of Physics, Oxford University, Oxford, UK
| | - J. Xia
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
| | - Y.-H. Xu
- Physics Department, Lancaster University, Lancaster, UK
| | - K. Yamamoto
- Department of Physics, Osaka Metropolitan University, Osaka, Japan
- Nambu Yoichiro Institute of Theoretical and Experimental Physics (NITEP), Osaka, Japan
| | - T. Yamamoto
- Department of Physics, Osaka Metropolitan University, Osaka, Japan
| | - C. Yanagisawa
- Department of Physics and Astronomy, State University of New York at Stony Brook, Stony Brook, NY USA
- Science Department, BMCC/CUNY, New York, NY USA
| | - G. Yang
- Department of Physics and Astronomy, State University of New York at Stony Brook, Stony Brook, NY USA
| | - T. Yano
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
| | - K. Yasutome
- Department of Physics, Kyoto University, Kyoto, Japan
| | - N. Yershov
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
| | - U. Yevarouskaya
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Paris, France
| | - M. Yokoyama
- Department of Physics, University of Tokyo, Tokyo, Japan
- Kavli IPMU (WPI), The University of Tokyo, Tokyo, Japan
| | - Y. Yoshimoto
- Department of Physics, University of Tokyo, Tokyo, Japan
| | - N. Yoshimura
- Department of Physics, Kyoto University, Kyoto, Japan
| | - M. Yu
- Department of Physics, Yokohama National University, Yokohama, Japan
| | - R. Zaki
- Department of Physics and Astronomy, York University, Toronto, ON Canada
| | - A. Zalewska
- H. Niewodniczanski Institute of Nuclear Physics PAN, Cracow, Poland
| | - J. Zalipska
- National Centre for Nuclear Research, Warsaw, Poland
| | - K. Zaremba
- Institute of Radioelectronics and Multimedia Technology, Warsaw University of Technology, Warsaw, Poland
| | - G. Zarnecki
- H. Niewodniczanski Institute of Nuclear Physics PAN, Cracow, Poland
| | - X. Zhao
- Institute for Particle Physics and Astrophysics, ETH Zurich, Zurich, Switzerland
| | - T. Zhu
- Department of Physics, Imperial College London, London, UK
| | - M. Ziembicki
- Institute of Radioelectronics and Multimedia Technology, Warsaw University of Technology, Warsaw, Poland
| | - E. D. Zimmerman
- Department of Physics, University of Colorado at Boulder, Boulder, CO USA
| | - M. Zito
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Paris, France
| | - S. Zsoldos
- Department of Physics, King’s College London, Strand, London, WC2R 2LS UK
| | - T2K Collaboration
- Department of Theoretical Physics, University Autonoma Madrid, 28049 Madrid, Spain
- Laboratory for High Energy Physics (LHEP), Albert Einstein Center for Fundamental Physics, University of Bern, Bern, Switzerland
- Department of Physics, Boston University, Boston, MA USA
- Department of Physics and Astronomy, University of California, Irvine, Irvine, CA USA
- IRFU, CEA, Université Paris-Saclay, 91191 Gif-sur-Yvette, France
- Department of Physics, University of Colorado at Boulder, Boulder, CO USA
- Department of Physics, Colorado State University, Fort Collins, Colorado USA
- Department of Physics, Duke University, Durham, NC USA
- Department of Atomic Physics, Eötvös Loránd University, Budapest, Hungary
- Institute for Particle Physics and Astrophysics, ETH Zurich, Zurich, Switzerland
- CERN European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
- Section de Physique, DPNC, University of Geneva, Geneva, Switzerland
- School of Physics and Astronomy, University of Glasgow, Glasgow, UK
- H. Niewodniczanski Institute of Nuclear Physics PAN, Cracow, Poland
- High Energy Accelerator Research Organization (KEK), Tsukuba, Ibaraki Japan
- Department of Physics, University of Houston, Houston, TX USA
- Institut de Fisica d’Altes Energies (IFAE)-The Barcelona Institute of Science and Technology, Campus UAB, Bellaterra, Barcelona Spain
- Institut für Physik, Johannes Gutenberg-Universität Mainz, Staudingerweg 7, 55128 Mainz, Germany
- IFIC (CSIC and University of Valencia), Valencia, Spain
- Institute For Interdisciplinary Research in Science and Education (IFIRSE), ICISE, Quy Nhon, Vietnam
- Department of Physics, Imperial College London, London, UK
- Dipartimento Interuniversitario di Fisica, INFN Sezione di Bari and Università e Politecnico di Bari, Bari, Italy
- Dipartimento di Fisica, INFN Sezione di Napoli and Università di Napoli, Naples, Italy
- Dipartimento di Fisica, INFN Sezione di Padova and Università di Padova, Padua, Italy
- INFN Sezione di Roma and Università di Roma “La Sapienza”, Rome, Italy
- Institute for Nuclear Research of the Russian Academy of Sciences, Moscow, Russia
- International Centre of Physics, Institute of Physics (IOP), Vietnam Academy of Science and Technology (VAST), 10 Dao Tan, Ba Dinh, Hanoi, Vietnam
- ILANCE, CNRS-University of Tokyo International Research Laboratory, Kashiwa, Chiba 277-8582 Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo Institutes for Advanced Study, University of Tokyo, Kashiwa, Chiba Japan
- Department of Physics, Keio University, Yokohama, Kanagawa Japan
- Department of Physics, King’s College London, Strand, London, WC2R 2LS UK
- Kobe University, Kobe, Japan
- Department of Physics, Kyoto University, Kyoto, Japan
- Physics Department, Lancaster University, Lancaster, UK
- Lawrence Berkeley National Laboratory, Berkeley, CA 94720 USA
- Laboratoire Leprince-Ringuet, Ecole Polytechnique, IN2P3-CNRS, Palaiseau, France
- Department of Physics, University of Liverpool, Liverpool, UK
- Department of Physics and Astronomy, Louisiana State University, Baton Rouge, LA USA
- Joint Institute for Nuclear Research, Dubna, Moscow Region Russia
- Department of Physics and Astronomy, Michigan State University, East Lansing, MI USA
- Department of Physics, Miyagi University of Education, Sendai, Japan
- National Centre for Nuclear Research, Warsaw, Poland
- Department of Physics and Astronomy, State University of New York at Stony Brook, Stony Brook, NY USA
- Department of Physics, Okayama University, Okayama, Japan
- Department of Physics, Osaka Metropolitan University, Osaka, Japan
- Department of Physics, Oxford University, Oxford, UK
- Department of Physics and Astronomy, University of Pennsylvania, Philadelphia, PA 19104 USA
- Department of Physics and Astronomy, University of Pittsburgh, Pittsburgh, PA USA
- School of Physics and Astronomy, Queen Mary University of London, London, UK
- Department of Physics, University of Regina, Regina, Saskatchewan Canada
- Department of Physics and Astronomy, University of Rochester, Rochester, NY USA
- Department of Physics, Royal Holloway University of London, Egham, Surrey UK
- III. Physikalisches Institut, RWTH Aachen University, Aachen, Germany
- Departamento de Física Atómica, Molecular y Nuclear, Universidad de Sevilla, 41080 Sevilla, Spain
- Department of Physics and Astronomy, University of Sheffield, Sheffield, UK
- Institute of Physics, University of Silesia, Katowice, Poland
- Laboratoire de Physique Nucléaire et de Hautes Energies (LPNHE), Sorbonne Université, Université Paris Diderot, CNRS/IN2P3, Paris, France
- Rutherford Appleton Laboratory, STFC, Harwell, Oxford, UK
- Department of Physics, University of Tokyo, Tokyo, Japan
- Kamioka Observatory, Institute for Cosmic Ray Research, University of Tokyo, Kamioka, Japan
- Research Center for Cosmic Neutrinos, Institute for Cosmic Ray Research, University of Tokyo, Kashiwa, Japan
- Department of Physics, Tokyo Institute of Technology, Tokyo, Japan
- Department of Physics, Tokyo Metropolitan University, Tokyo, Japan
- Department of Physics, Faculty of Science and Technology, Tokyo University of Science, Noda, Chiba Japan
- Department of Physics, University of Toronto, Toronto, ON Canada
- TRIUMF, Vancouver, BC Canada
- Faculty of Physics, University of Warsaw, Warsaw, Poland
- Institute of Radioelectronics and Multimedia Technology, Warsaw University of Technology, Warsaw, Poland
- Department of Physics, Faculty of Science, Tohoku University, Sendai, Miyagi Japan
- Department of Physics, University of Warwick, Coventry, UK
- Department of Physics, University of Winnipeg, Winnipeg, MB Canada
- Faculty of Physics and Astronomy, Wroclaw University, Wrocław, Poland
- Department of Physics, Yokohama National University, Yokohama, Japan
- Department of Physics and Astronomy, York University, Toronto, ON Canada
- Université Paris-Saclay, Gif-sur-Yvette, France
- INFN-Laboratori Nazionali di Legnaro, Legnaro, Italy
- J-PARC, Tokai, Japan
- Kavli IPMU (WPI), The University of Tokyo, Tokyo, Japan
- Moscow Institute of Physics and Technology (MIPT), Moscow Region, Russia and National Research Nuclear University “MEPhI”, Moscow, Russia
- IPSA-DRII, Ivry-sur-Seine, France
- The Graduate University of Science and Technology, Vietnam Academy of Science and Technology, Ho Chi Minh City, Vietnam
- JINR, Dubna, Russia
- Nambu Yoichiro Institute of Theoretical and Experimental Physics (NITEP), Osaka, Japan
- Science Department, BMCC/CUNY, New York, NY USA
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5
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Nimura Y, Madeda Y, Tamura E, Kouyama Y, Matsudaira S, Nakamura H, Misawa M, Miyachi H, Baba T, Mukai S, Sawada N, Ishida F, Nemoto T, Kudo SE. Gastrointestinal: Real-time observation of rectal malignant lymphoma using endocytoscopy for differentiation from adenocarcinoma. J Gastroenterol Hepatol 2023; 38:1456. [PMID: 36863707 DOI: 10.1111/jgh.16155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/14/2023] [Accepted: 02/19/2023] [Indexed: 03/04/2023]
Affiliation(s)
- Y Nimura
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Y Madeda
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - E Tamura
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - Y Kouyama
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - S Matsudaira
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - H Nakamura
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - M Misawa
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - H Miyachi
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - T Baba
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - S Mukai
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - N Sawada
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - F Ishida
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - T Nemoto
- Department of Diagnostic Pathology, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
| | - S-E Kudo
- Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
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6
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Furuta T, Negoto T, Miyoshi H, Moritsubo M, Nakamura H, Morioka M, Akiba J, Ohshima K, Sugita Y. Intratumoral thrombosis as a histological biomarker for predicting epidermal growth factor receptor alteration and poor prognosis in patients with glioblastomas. J Neurooncol 2023; 164:633-641. [PMID: 37710025 DOI: 10.1007/s11060-023-04447-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 09/07/2023] [Indexed: 09/16/2023]
Abstract
PURPOSE Intratumoral thrombosis is a specific finding in glioblastomas and considered the origin of palisading necrosis. Its distribution and contribution to the glioblastoma pathophysiology and systemic thrombosis are obscure, although deep vein thrombosis is a common complication in glioblastoma cases. METHODS Clinicopathological and genetic analyses were performed on 97 glioblastoma tissue specimens to elucidate the role of thrombotic events and associated molecular abnormalities. RESULTS Morphologically, intratumoral thrombosis was observed more frequently in vessels composed of single-layered CD34-positive endothelium and/or αSMA-positive pericytes in the tumor periphery, compared to microvascular proliferation with multi-channeled and pericyte-proliferating vessels in the tumor center. Intratumoral thrombosis was significantly correlated with the female sex, high preoperative D-dimer levels, and epidermal growth factor receptor (EGFR) amplification. The presence of one or more thrombi in 20 high-power fields was a predictive marker of EGFR amplification, with a sensitivity of 81.5% and specificity of 52.6%. RNA sequencing demonstrated that the group with many thrombi had higher EGFR gene expression levels than the group with few thrombi. The tumor cells invading along the vessels in the tumor periphery were positive for wild-type EGFR but negative for EGFRvIII, whereas the cells around the microvascular proliferation (MVP) in the tumor center were positive for both wild-type EGFR and EGFRvIII. Intratumoral thrombosis is an independent poor prognostic factor. CONCLUSIONS Aberrant but exquisitely regulated EGFR can induce thrombosis in non-MVP vessels in the tumor invasion area and then promote palisading necrosis, followed by hypoxia, abnormal angiogenesis, and further tumor cell invasion.
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Affiliation(s)
- Takuya Furuta
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan.
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan.
- Department of Pathology, Kurume University School of Medicine, 67 Asahi-machi, Kurume, Fukuoka, 830-0011, Japan.
| | - Tetsuya Negoto
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Hideo Nakamura
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Yasuo Sugita
- Department of Neuropathology, St. Mary's Hospital, Kurume, Japan
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7
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Rani K, Ozaki N, Hironaka Y, Hashimoto K, Kodama R, Mukai K, Nakamura H, Takai S, Nagatomo H. Prediction of the superimposed laser shot number for copper using a deep convolutional neural network. Opt Express 2023; 31:24045-24053. [PMID: 37475241 DOI: 10.1364/oe.491420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/14/2023] [Indexed: 07/22/2023]
Abstract
Image-based deep learning (IBDL) is an advanced technique for predicting the surface irradiation conditions of laser surface processing technology. In pulsed-laser surface processing techniques, the number of superimposed laser shots is one of the fundamental and essential parameters that should be optimized for each material. Our primary research aims to build an adequate dataset using laser-irradiated surface images and to successfully predict the number of superimposed shots using the pre-trained deep convolutional neural network (CNN) models. First, the laser shot experiments were performed on copper targets using a nanosecond YAG laser with a wavelength of 532 nm. Then, the training data were obtained with the different superimposed shots of 1 to 1024 in powers of 2. After that, we used several pre-trained deep CNN models to predict the number of superimposed laser shots. Based on the dataset with 1936 images, VGG16 shows a high validation accuracy, higher sensitivity, and more than 99% precision than other deep CNN models. Utilizing the VGG16 model with high sensitivity could positively impact the industries' time, efficiency, and overall production.
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8
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Yamashita S, Takeshima H, Hata N, Uchida H, Shinojima N, Yokogami K, Nakano Y, Sakata K, Fudaba H, Enomoto T, Nakahara Y, Ujifuku K, Sugawara K, Iwaki T, Sangatsuda Y, Yoshimoto K, Hanaya R, Mukasa A, Suzuki K, Yamamoto J, Negoto T, Nakamura H, Momii Y, Fujiki M, Abe H, Masuoka J, Abe T, Matsuo T, Ishiuchi S. Clinicopathologic analysis of pineal parenchymal tumors of intermediate differentiation: a multi-institutional cohort study by the Kyushu Neuro-Oncology Study Group. J Neurooncol 2023; 162:425-433. [PMID: 37052748 DOI: 10.1007/s11060-023-04310-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/05/2023] [Indexed: 04/14/2023]
Abstract
PURPOSE Pineal parenchymal tumors of intermediate differentiation (PPTIDs), which were recognized in the 2007 World Health Organization (WHO) classification, are rare, accounting for less than 1% of all central nervous system tumors. This rarity and novelty complicate the diagnosis and treatments of PPTID. We therefore aimed to evaluate the clinicopathological significance of this tumor. METHODS At 11 institutions participating in the Kyushu Neuro-Oncology Study Group, data for patients diagnosed with PPTID were collected. Central pathology review and KBTBD4 mutation analysis were applied to attain the diagnostically accurate cohort. RESULTS PPTID was officially diagnosed in 28 patients: 11 (39%) with WHO grade 2 and 17 (61%) with WHO grade 3 tumors. Median age was 49 years, and the male:female ratio was 1:2.1. Surgery was attempted in all 28 patients, and gross total resection (GTR) was achieved in 46% (13/28). Adjuvant radiotherapy and chemotherapy were administered to, respectively, 82% (23/28) and 46% (13/28). The 5-year progression-free survival (PFS) and overall survival rates were 64.9% and 70.4% respectively. Female sex (p = 0.018) and GTR (p < 0.01) were found to be independent prognostic factors for PFS and female sex (p = 0.019) was that for OS. Initial and second recurrences were most often leptomeningeal (67% and 100% respectively). 80% (20/25) of patients harbored a KBTBD4 mutation. CONCLUSIONS Female sex and GTR were independent prognostic factors in our patients with PPTID. Leptomeningeal recurrence was observed to be particularly characteristic of this tumor. The rate of KBTBD4 mutation observed in our cohort was acceptable and this could prove the accuracy of our PPTID cohort.
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Affiliation(s)
- Shinji Yamashita
- Division of Neurosurgery, Department of Clinical Neuroscience, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan.
| | - Hideo Takeshima
- Division of Neurosurgery, Department of Clinical Neuroscience, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Nobuhiro Hata
- Department of Neurosurgery, Oita University Faculty of Medicine, Oita, Japan
| | - Hiroyuki Uchida
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Naoki Shinojima
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kiyotaka Yokogami
- Division of Neurosurgery, Department of Clinical Neuroscience, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki, 889-1692, Japan
| | - Yoshiteru Nakano
- Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Hirotaka Fudaba
- Department of Neurosurgery, Oita University Faculty of Medicine, Oita, Japan
| | - Toshiyuki Enomoto
- Department of Neurosurgery, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Yukiko Nakahara
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Kenta Ujifuku
- Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kenichi Sugawara
- Department of Neurosurgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
| | - Tooru Iwaki
- Department of Neuropathology, Neurological Institute, Graduate School of Medical Sciences, Kyusyu University, Fukuoka, Japan
| | - Yuhei Sangatsuda
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koji Yoshimoto
- Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryousuke Hanaya
- Department of Neurosurgery, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Kohei Suzuki
- Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Junkoh Yamamoto
- Department of Neurosurgery, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Tetsuya Negoto
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Hideo Nakamura
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | - Yasutomo Momii
- Department of Neurosurgery, Oita University Faculty of Medicine, Oita, Japan
| | - Minoru Fujiki
- Department of Neurosurgery, Oita University Faculty of Medicine, Oita, Japan
| | - Hiroshi Abe
- Department of Neurosurgery, Fukuoka University School of Medicine, Fukuoka, Japan
| | - Jun Masuoka
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Tatsuya Abe
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Takayuki Matsuo
- Department of Neurosurgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shogo Ishiuchi
- Department of Neurosurgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
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Otsu Y, Kajiwara S, Hashimoto A, Sakata K, Negoto T, Hasegawa Y, Nakamura H, Hirohata M, Morioka M. Effects of Microvascular Decompression on Pain Relief and Quality of Life in Late Elderly Patients with Trigeminal Neuralgia. Neurol Med Chir (Tokyo) 2023. [PMID: 37019653 DOI: 10.2176/jns-nmc.2022-0288] [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: 04/07/2023] Open
Abstract
Pharmacotherapy is frequently selected over surgical interventions for late elderly patients with trigeminal neuralgia (TN). However, medication may affect these patients' activities of daily living (ADL). Hence, we investigated the effect of the surgical treatment of TN on ADL in older patients. This study included 11 late elderly patients >75 years old and 26 nonlate elderly patients who underwent microvascular decompression (MVD) for TN at our hospital from June 2017 to August 2021. We evaluated pre- and postsurgical ADL using the Barthel Index (BI) score, side effects of antineuralgic drugs, the BNI pain intensity score, and perioperative medication. The BI score of late elderly patients significantly improved postoperatively, particularly in transfer (pre: 10.5; post: 13.2), mobility (pre: 10; post: 12.7), and feeding (pre: 5.9 points; post: 10 points). Additionally, antineuralgic drugs caused preoperative disturbances of transfer and mobility. Trends of a longer disease duration and frequent occurrence of side effects were observed in all patients in the elderly group, compared to only 9 out of 26 patients in the younger group (100% vs. 35%, p = 0.0002). In addition, drowsiness was observed more frequently in the late elderly group (73% vs. 23%, p = 0.0084). However, the change in scores indicating improvement after surgery was significantly greater in the late elderly group, although both pre- and postoperative scores were higher in the nonlate elderly group (11.4 ± 1.9 vs. 6.9 ± 0.7, p = 0.027). Surgical treatment can improve older patients' ADL because it relieves pain and facilitates discontinuation of antineuralgic drugs. Consequently, MVD can be positively recommended for older patients with TN if general anesthesia is acceptable.
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Affiliation(s)
- Yusuke Otsu
- Department of Neurosurgery, Kurume University School of Medicine
| | - Sosho Kajiwara
- Department of Neurosurgery, Kurume University School of Medicine
| | - Aya Hashimoto
- Department of Neurosurgery, Kurume University School of Medicine
| | - Kiyohiko Sakata
- Department of Neurosurgery, Kurume University School of Medicine
| | - Tetsuya Negoto
- Department of Neurosurgery, Kurume University School of Medicine
| | - Yu Hasegawa
- Department of Neurosurgery, Kurume University School of Medicine
- Department of Pharmaceutical Sciences, International University of Health and Welfare
| | - Hideo Nakamura
- Department of Neurosurgery, Kurume University School of Medicine
| | - Masaru Hirohata
- Department of Neurosurgery, Kurume University School of Medicine
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine
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10
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Ozawa K, Nakamura H, Shimamura K, Dietze G, Yoshikawa H, Zoueshtiagh F, Kurose K, Mu L, Ueno I. Capillary-driven horseshoe vortex forming around a micro-pillar. J Colloid Interface Sci 2023; 642:227-234. [PMID: 37004257 DOI: 10.1016/j.jcis.2023.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/22/2023] [Accepted: 03/05/2023] [Indexed: 03/17/2023]
Abstract
HYPOTHESIS Horseshoe vortices are known to emerge around large-scale obstacles, such as bridge pillars, due to an inertia-driven adverse pressure gradient forming on the upstream-side of the obstacle. We contend that a similar flow structure can arise in thin-film Stokes flow around micro-obstacles, such as used in textured surfaces to improve wettability. This could be exploited to enhance mixing in microfluidic devices, typically limited to creeping-flow regimes. EXPERIMENTS Numerical simulations based on the Navier-Stokes equations are carried out to elucidate the flow structure associated with the wetting dynamics of a liquid film spreading around a 50 μm diameter micro-pillar. The employed multiphase solver, which is based on the volume of fluid method, accurately reproduces the wetting dynamics observed in current and previous (Mu et al., Langmuir, 2019) experiments. FINDINGS The flow structure within the liquid meniscus forming at the foot of the micro-pillar evinces a horseshoe vortex wrapping around the obstacle, notwithstanding that the Reynolds number in our system is extremely low. Here, the adverse pressure gradient driving flow reversal near the bounding wall is caused by capillarity instead of inertia. The horseshoe vortex is entangled with other vortical structures, leading to an intricate flow system with high-potential mixing capabilities.
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Sakata K, Hashimoto A, Kotaki Y, Yoshitake H, Shimokawa S, Komaki S, Nakamura H, Furuta T, Morioka M. Successful Treatment of Pure Aqueductal Pilomyxoid Astrocytoma and Arrested Hydrocephalus With Endoscopic Tumor Resection Followed by Chemotherapy: A Case Report and Technical Considerations. Neurosurgery Open 2023. [DOI: 10.1227/neuprac.0000000000000030] [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: 02/05/2023] Open
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12
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Muragaki Y, Ishikawa E, Maruyama T, Nitta M, Saito T, Ikuta S, Komori T, Kawamata T, Yamamoto T, Tsuboi K, Matsumura A, Nakamura H, Kuroda J, Abe T, Momii Y, Saito R, Tominaga T, Tabei Y, Suzuki I, Arakawa Y, Miyamoto S, Matsutani M, Karasawa K, Nakazato Y, Maebayashi K, Hashimoto K, Ohno T. A multicenter, randomized, placebo-controlled phase IIb trial of an autologous formalin-fixed tumor vaccine for newly diagnosed glioblastomas. J Neurosurg 2023:1-11. [PMID: 36670529 DOI: 10.3171/2022.12.jns221221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 12/07/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE An autologous formalin-fixed tumor vaccine (AFTV) derived from resected glioblastoma (GBM) tissue can be used against unidentified tumor antigens. Thus, the authors conducted a multicenter double-blind phase IIb trial to investigate the efficacy of an AFTV. METHODS Eligible patients were adults with supratentorial GBMs, 16-75 years of age, with Karnofsky Performance Scale (KPS) scores ≥ 60%, and no long-term steroid administration. An AFTV comprising fixed paraffin-embedded tumor tissue with immune adjuvants or an identical placebo without fixed tumor tissue was injected intradermally over three courses before and after chemoradiotherapy. The primary and secondary end points were overall survival (OS), progression-free survival (PFS), and 3-year survival rate. RESULTS Sixty-three patients were enrolled. The average patient age was 61 years. The median KPS score was 80%, and the median resection rate was 95%. The full analysis set of 57 patients indicated no significant difference in OS (p = 0.64) for the AFTV group (median OS 25.6 months, 3-year OS rate 38%) compared with the placebo group (31.5 months and 41%, respectively) and no difference in PFS (median PFS 13.3 months in both groups, p = 0.98). For patients with imaging-based total tumor removal, the 3-year PFS rate was 81% in the AFTV group versus 46% in the placebo group (p = 0.067), whereas the 3-year OS rate was 80% versus 54% (p = 0.16), respectively. Similar results were obtained in the p53-negative subgroups. Severe adverse effects were not observed. CONCLUSIONS The AFTV may have potential effects in certain patient subgroups. A phase III study for patients with total tumor removal remains warranted to confirm these findings. Clinical trial registration no.: UMIN000010602 (UMIN Clinical Trials Registry).
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Affiliation(s)
- Yoshihiro Muragaki
- 1Department of Neurosurgery, Tokyo Women's Medical University, Tokyo
- 2Center for Advanced Medical Engineering Research and Development, Kobe University, Hyogo
| | | | - Takashi Maruyama
- 1Department of Neurosurgery, Tokyo Women's Medical University, Tokyo
| | - Masayuki Nitta
- 1Department of Neurosurgery, Tokyo Women's Medical University, Tokyo
| | - Taiichi Saito
- 1Department of Neurosurgery, Tokyo Women's Medical University, Tokyo
| | - Soko Ikuta
- 1Department of Neurosurgery, Tokyo Women's Medical University, Tokyo
| | - Takashi Komori
- 2Center for Advanced Medical Engineering Research and Development, Kobe University, Hyogo
- 4Tokyo Metropolitan Neurological Hospital, Tokyo
| | - Takakazu Kawamata
- 1Department of Neurosurgery, Tokyo Women's Medical University, Tokyo
| | | | - Koji Tsuboi
- 6Proton Medical Research Center, Faculty of Medicine, University of Tsukuba, Ibaraki
| | | | - Hideo Nakamura
- 7Department of Neurosurgery, Kumamoto University, Kumamoto
| | | | - Tatsuya Abe
- 8Department of Neurosurgery, Oita University, Oita
| | | | - Ryuta Saito
- 9Department of Neurosurgery, Tohoku University, Miyagi
| | | | - Yusuke Tabei
- 10Department of Neurosurgery, Japan Red Cross Medical Center, Tokyo
| | - Ichiro Suzuki
- 10Department of Neurosurgery, Japan Red Cross Medical Center, Tokyo
| | - Yoshiki Arakawa
- 11Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto
| | - Susumu Miyamoto
- 11Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto
| | | | | | | | | | - Koichi Hashimoto
- 16Tsukuba Clinical Research and Development Organization, University of Tsukuba, Ibaraki; and
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Negoto T, Komaki S, Hashimoto A, Yoshitake H, Moritsubo M, Furuta T, Sakata K, Nakamura H, Morioka M. CBMS-4 CHROMOSOMAL INSTABILITY IN GLIOMA USING SPECTRAL KARYOTYPING METHOD. Neurooncol Adv 2022. [DOI: 10.1093/noajnl/vdac167.003] [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: 12/05/2022] Open
Abstract
Abstract
Introduction
Chromosomal instability, the cell condition in which chromosome mis-segregation occur at a high frequency during cell division, has been considered to be involved in the molecular mechanisms that give rise to the complex genetic background of glioma. However, most of this phenomenon has been based on researches using cell line, and there have been few studies of chromosomal instability in clinical specimens of gliomas.
Methods
Primary cell culture was obtained from 11 glioma specimens (eight Glioblastoma (GBM), one Anaplastic PXA (aPXA), one Astrocytoma, and one Ependymoma), which was removed at our hospital, and chromosomes of up to five cells per case were analyzed by the SKY method. Chromosome instability was quantified by two parameters, one was AS (Aneuploidy score), which means the number of gain or loss of whole of the chromosome, and the other was SS: Structural abnormality score, which means the number of chromosome structural abnormality per cell. In addition, the phenotypes, which were characteristic of chromosomal instability were observed individually.
Results
Each quantitative value was as follows: GBM; AS:2.30±0.51 /SS:1.64±0.38, aPXA; AS :1.40±1.33 / SS:8.20±0.99, Astrocytoma and Ependymoma; AS:0.00 /SS:0.00, suggesting that chromosomal instability was associated with GBM and aPXA. Chromosome 7 amplification was most frequent in GBM (57%), and Mosaic loss of chromosome Y was also observed in 60% of males. Some characteristic karyotypes which suggest the phenomenon of Chromothripsis or Double minute were also observed. The karyotype concordance rate in the cases with p53 mutation was 60%, and that with p53 wild type was 100%, indicating that the p53 mutation increased the genotype heterogeneity in the same specimen.
Discussion
In clinical specimens of gliomas, aneuploidy and structural abnormalities were identified in GBM and aPXA, suggesting that chromosomal instability contributes to their cellular phenotype and malignancy.
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Affiliation(s)
- Tetsuya Negoto
- Department of Neurosurgery, Kurume University of Medicine , Fukuoka , Japan
| | - Satoru Komaki
- Department of Neurosurgery, Kurume University of Medicine , Fukuoka , Japan
| | - Aya Hashimoto
- Department of Neurosurgery, Kurume University of Medicine , Fukuoka , Japan
| | - Hidenori Yoshitake
- Department of Neurosurgery, Kurume University of Medicine , Fukuoka , Japan
| | - Mayuko Moritsubo
- Department of Pathology, Kurume University of Medicine , Fukuoka , Japan
| | - Takuya Furuta
- Department of Pathology, Kurume University of Medicine , Fukuoka , Japan
| | - Kiyohiko Sakata
- Department of Neurosurgery, Kurume University of Medicine , Fukuoka , Japan
| | - Hideo Nakamura
- Department of Neurosurgery, Kurume University of Medicine , Fukuoka , Japan
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University of Medicine , Fukuoka , Japan
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Yoshitake H, Negoto T, Komaki S, Nakamura H, Morioka M. ML-5 THE TRANSITION OF THE TREATMENT OF 60 PCNSL CASES AT OUR INSTITUTION AND CLINICAL CONSIDERATIONS. Neurooncol Adv 2022. [DOI: 10.1093/noajnl/vdac167.079] [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: 12/05/2022] Open
Abstract
Abstract
The efficacy of RMPV-A (rituximab, methotrexate, procarbazine, vincristine, and cytarabine) and whole brain irradiation for primary central nervous system lymphoma (PCNSL) have recently been reported. Our institution also introduced RMPV therapy in 2020 after an era of conventional HD-MTX to cytarabine and rituximab combination. In this report, we analyzed 60 PCNSL cases treated from 2013 to 2021.There were 32 female patients (53%) with a median age of 70 years (30-87). Five patients (8%) received radiotherapy alone as initial treatment, 30 (50%) received HD-MTX (including radiation), 17 (28%) received HD-MTX plus rituximab or cytarabine, and 9 (13%) received RMPV therapy. The response rate (CR, CRu, PR) in the HD-MTX group was 88%, and the complete response rate (CR, CRu) was 51%. In contrast, the RMPV arm had a response rate of 100% and a complete response rate of 6 patients (66.7%). 7 patients (14%) in the HD-MTX arm and 2 patients (22%) in the RMPV arm were unable to continue treatment due to adverse events. The treatment of PCNSL has undergone significant changes in recent years, with the availability of RMPV-A, thiotepa, and tirabrutinib, and it is now possible to construct treatment that avoids leukoencephalopathy caused by radiation therapy as much as possible, which had been a major problem of conventional therapy. However, because of the use of strong drugs, caution must be exercised when treating patients in poor general conditions, especially the elderly. However, the present analysis indicates that many elderly patients can be successfully treated with careful observation. In the future, it is essential to accumulate cases treated with RMPV therapy and tilabrutinib and conduct further data analysis to establish a new generation of treatment for PCNSL.
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Affiliation(s)
- Hidenobu Yoshitake
- The Department of Neurosurgery, Kurume University School of Medicine , Fukuoka , Japan
| | - Tetsuya Negoto
- The Department of Neurosurgery, Kurume University School of Medicine , Fukuoka , Japan
| | - Satoru Komaki
- The Department of Neurosurgery, Kurume University School of Medicine , Fukuoka , Japan
| | - Hideo Nakamura
- The Department of Neurosurgery, Kurume University School of Medicine , Fukuoka , Japan
| | - Motohiro Morioka
- The Department of Neurosurgery, Kurume University School of Medicine , Fukuoka , Japan
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15
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Kajiwara S, Nakamura H, Sakata K, Komaki S, Negoto T, Morioka M. Endoscopic aqueductal membrane fenestration was effective for intractable hydrocephalus after removal of a nongerminomatous germ cell tumor exhibiting growing teratoma syndrome: a case report. BMC Pediatr 2022; 22:683. [PMID: 36443673 PMCID: PMC9703769 DOI: 10.1186/s12887-022-03743-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 11/10/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Primary central nervous system (CNS) germ cell tumors (GCTs) are rare neoplasms predominantly observed in the pediatric and young adult populations. A mixed GCT including immature teratoma exhibiting growing teratoma syndrome is presented. The pathogenesis of growing teratoma syndrome remains unclear, and its treatment strategy has not been established. GCTs are often located within the ventricles, causing hydrocephalus, which sometimes improves after removal of the tumor due to restoration of cerebrospinal fluid (CSF) flow. On the other hand, even if the flow route of CSF from the third ventricle to arachnoid granulations on the brain surface quadrigeminal cistern is restored after removal of the tumor, hydrocephalus may not improve. CASE PRESENTATION A case whose intractable hydrocephalus improved after penetrating the aqueductal membrane via endoscopy is described. An 11-year-old boy was treated for pineal intracranial growing teratoma syndrome (IGTS). The tumor grew rapidly in a short period, and hydrocephalus progressed despite endoscopic third ventriculostomy (ETV). Although the obstruction was removed by radiation, chemotherapy, and total tumor resection, the hydrocephalus did not improve. Endoscopic membrane perforation was performed because a membrane-like structure was seen at the entrance of the cerebral aqueduct on magnetic resonance imaging. The hydrocephalus improved immediately after the operation, and the patient's consciousness disturbance also improved significantly. CONCLUSION The purpose of this report is to update the current knowledge and standards of management for patients with growing teratoma syndrome, as well as to drive future translational and clinical studies by recognizing the unmet needs concerning hydrocephalus.
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Affiliation(s)
- Sosho Kajiwara
- grid.410781.b0000 0001 0706 0776Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume City, Fukuoka, 830-0011 Japan
| | - Hideo Nakamura
- grid.410781.b0000 0001 0706 0776Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume City, Fukuoka, 830-0011 Japan
| | - Kiyohiko Sakata
- grid.410781.b0000 0001 0706 0776Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume City, Fukuoka, 830-0011 Japan
| | - Satoru Komaki
- grid.410781.b0000 0001 0706 0776Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume City, Fukuoka, 830-0011 Japan
| | - Tetsuya Negoto
- grid.410781.b0000 0001 0706 0776Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume City, Fukuoka, 830-0011 Japan
| | - Motohiro Morioka
- grid.410781.b0000 0001 0706 0776Department of Neurosurgery, Kurume University School of Medicine, 67 Asahimachi, Kurume City, Fukuoka, 830-0011 Japan
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16
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Nagane M, Ichimura K, Onuki R, Narushima D, Honda-Kitahara M, Satomi K, Tomiyama A, Arai Y, Shibata T, Narita Y, Uzuka T, Nakamura H, Nakada M, Arakawa Y, Ohnishi T, Mukasa A, Tanaka S, Wakabayashi T, Aoki T, Aoki S, Shibui S, Matsutani M, Ishizawa K, Yokoo H, Suzuki H, Morita S, Kato M, Nishikawa R. Bevacizumab beyond Progression for Newly Diagnosed Glioblastoma (BIOMARK): Phase II Safety, Efficacy and Biomarker Study. Cancers (Basel) 2022; 14:cancers14225522. [PMID: 36428615 PMCID: PMC9688169 DOI: 10.3390/cancers14225522] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/27/2022] [Accepted: 11/04/2022] [Indexed: 11/12/2022] Open
Abstract
We evaluated the efficacy and safety of bevacizumab beyond progression (BBP) in Japanese patients with newly diagnosed glioblastoma and explored predictors of response to bevacizumab. This phase II study evaluated a protocol-defined primary therapy by radiotherapy with concurrent and adjuvant temozolomide plus bevacizumab, followed by bevacizumab monotherapy, and secondary therapy (BBP: bevacizumab upon progression). Ninety patients received the protocol-defined primary therapy (BBP group, n = 25). Median overall survival (mOS) and median progression-free survival (mPFS) were 25.0 and 14.9 months, respectively. In the BBP group, in which O6-methylguanine-DNA methyltransferase (MGMT)-unmethylated tumors predominated, mOS and mPFS were 5.8 and 1.9 months from BBP initiation and 16.8 and 11.4 months from the initial diagnosis, respectively. The primary endpoint, the 2-year survival rate of the BBP group, was 27.0% and was unmet. No unexpected adverse events occurred. Expression profiling using RNA sequencing identified that Cluster 2, which was enriched with the genes involved in macrophage or microglia activation, was associated with longer OS and PFS independent of the MGMT methylation status. Cluster 2 was identified as a significantly favorable independent predictor for PFS, along with younger age and methylated MGMT. The novel expression classifier may predict the prognosis of glioblastoma patients treated with bevacizumab.
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Affiliation(s)
- Motoo Nagane
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo 181-8611, Japan
- Correspondence: ; Tel.: +81-422-47-5511
| | - Koichi Ichimura
- Department of Brain Disease Translational Research, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
| | - Ritsuko Onuki
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Daichi Narushima
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Mai Honda-Kitahara
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Kaishi Satomi
- Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Arata Tomiyama
- Department of Brain Disease Translational Research, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan
| | - Yasuhito Arai
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Tatsuhiro Shibata
- Division of Cancer Genomics, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Takeo Uzuka
- Department of Neurosurgery, Dokkyo Medical University, Tochigi 321-0293, Japan
| | - Hideo Nakamura
- Department of Neurosurgery, Faculty of Life Sciences, Kumamoto University, Kumamoto 860-8555, Japan
| | - Mitsutoshi Nakada
- Department of Neurosurgery, Graduate School of Medical Sciences, Kanazawa University, Kanazawa 920-1192, Japan
| | - Yoshiki Arakawa
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Takanori Ohnishi
- Department of Neurosurgery, Graduate School of Medicine, Ehime University, Ehime 790-0052, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
| | - Shota Tanaka
- Department of Neurosurgery, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8654, Japan
| | - Toshihiko Wakabayashi
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Aichi 464-8601, Japan
| | - Tomokazu Aoki
- Department of Neurosurgery, Kyoto Medical Center, Kyoto 612-8555, Japan
| | - Shigeki Aoki
- Department of Radiology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
| | - Soichiro Shibui
- Department of Neurosurgery, Teikyo University Hospital, Kawasaki 213-8507, Japan
| | - Masao Matsutani
- Department of Neurosurgery, Kurosawa Hospital, Gunma 370-1203, Japan
| | - Keisuke Ishizawa
- Department of Pathology, Saitama Medical University, Saitama 350-0495, Japan
| | - Hideaki Yokoo
- Department of Human Pathology, Graduate School of Medicine, Gunma University, Gunma 371-8511, Japan
| | - Hiroyoshi Suzuki
- Department of Pathology and Laboratory Medicine, National Hospital Organization Sendai Medical Center, Miyagi 983-8520, Japan
| | - Satoshi Morita
- Department of Biomedical Statistics and Bioinformatics, Graduate School of Medicine, Kyoto University, Kyoto 606-8501, Japan
| | - Mamoru Kato
- Division of Bioinformatics, National Cancer Center Research Institute, Tokyo 104-0045, Japan
| | - Ryo Nishikawa
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama 350-1298, Japan
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Hojo K, Furuta T, Komaki S, Yoshikane Y, Kikuchi J, Nakamura H, Ide M, Shima S, Hiyoshi Y, Araki J, Tanaka S, Ozono S, Yoshida A, Nobusawa S, Morioka M, Nishikomori R. Systemic inflammation caused by an intracranial mesenchymal tumor with a
EWSR1
::
CREM
fusion presenting associated with
IL
‐6/
STAT3
signaling. Neuropathology 2022. [DOI: 10.1111/neup.12877] [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: 08/21/2022] [Revised: 10/11/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Keishiro Hojo
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
| | - Takuya Furuta
- Department of Pathology Kurume University School of Medicine Kurume Japan
| | - Satoru Komaki
- Department of Neurosurgery Kurume University School of Medicine Kurume Japan
| | - Yukako Yoshikane
- Department of Pediatrics Fukuoka University Chikushi Hospital Chikushino Japan
| | - Jin Kikuchi
- Department of Neurosurgery Kurume University School of Medicine Kurume Japan
| | - Hideo Nakamura
- Department of Neurosurgery Kurume University School of Medicine Kurume Japan
| | - Mizuki Ide
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
| | - Saho Shima
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
| | - Yusuke Hiyoshi
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
| | - Junichiro Araki
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
| | - Seiji Tanaka
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
| | - Shuichi Ozono
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
| | - Akihiko Yoshida
- Rare Cancer Center National Cancer Center Hospital Tokyo Japan
- Department of Diagnostic Pathology National Cancer Center Hospital Tokyo Japan
| | - Sumihito Nobusawa
- Department of Human Pathology Gunma University Graduate School of Medicine Maebashi Japan
| | - Motohiro Morioka
- Department of Neurosurgery Kurume University School of Medicine Kurume Japan
| | - Ryuta Nishikomori
- Department of Pediatrics and Child Health Kurume University School of Medicine Kurume Japan
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Murayama Y, Kitasato L, Ishizue N, Suzuki M, Mitani Y, Saito D, Matsuura G, Sato T, Kobayashi S, Nakamura H, Oikawa J, Kishihara J, Fukaya H, Niwano S, Ako J. Evaluation of the direct protective effects of Canagliflozin on the Isoproterenol-induced cell injury in rat cardiomyocytes. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2927] [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
Sodium-glucose cotransporter-2 (SGLT2) inhibitors are agents that act by inhibiting glucose and sodium reabsorption in the proximal renal tubule which promotes urinary glucose excretion. More recently, significant benefit data of SGLT2 inhibitors in patients with heart failure, independent of the presence of type 2 diabetes has been reported. We have previously demonstrated that Canagliflozin (Cana), a SGLT2 inhibitor, reduced the ventricular effective refractory period in isoproterenol (ISP)-induced myocardial injury rat model accompanied with the suppression of reactive oxygen species and the elevation of ketone bodies, suggesting the effect of Cana on electrical cardiac remodeling. The direct effect of Cana to the cardiomyocytes and its underlying molecular mechanism was remained to be clarified. We therefore established an ISP-induced neonatal rat ventricular cardiomyocyte (NRVCM) in vitro model, pretreated with Cana and/or ketone bodies.
Methods
Primary NRVCM were isolated from Wistar rats, were pretreated by Cana with or without βOHB (the most abundant ketone body in circulation), followed by a stimulation of ISP (10μM). Cells without drug or ketone body pretreatment were used as control. We then analyzed its effect on cell viability, apoptosis, and mitochondrial membrane potential using MTT assay, TUNEL assay, and mitochondrial membrane potential assay, respectively. MTT assay was also performed with or without PI3k inhibitor, LY294002. The end-labeling of DNA fragmentation were labelled with FITC, followed by the nuclei counterstain with DAPI and were observed with confocal microscope. The apoptotic index was defined as the percentage of TUNEL positive cells / total nuclei.
Results
Cana rescued the reduction of NRVCM cell viability induced by ISP stimulation for 24 hours which was inhibited by LY294002 compared to cells without pretreatment. Interestingly, pretreatment of βOHB with or without Cana improved also the NRCVM cell viability whereas there was no significant difference between these two conditions or with cells treated with Cana only, suggesting the direct protective effect of Cana. In 48 hours of ISP stimulation, the apoptotic index intends to decrease in Cana and/or βOHB compared to cells without pretreatment (Figure 1). Although the mitochondrial function was maintained in Cana-pretreated cells compared to cells without pretreatment, there was no significant difference in βOHB-pretreated cells.
Conclusions
Cana has a direct protective effect on cardiomyocytes cell viability, apoptosis as well as the mitochondrial function impaired by ISP through the cell survival signaling PI3K/Akt pathway. This brings a new insight to the therapeutic target of cardiovascular disease.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- Y Murayama
- Kitasato University School of Medicine , Sagamihara , Japan
| | - L Kitasato
- Kitasato University School of Medicine , Sagamihara , Japan
| | - N Ishizue
- Kitasato University School of Medicine , Sagamihara , Japan
| | - M Suzuki
- Kitasato University School of Medicine , Sagamihara , Japan
| | - Y Mitani
- Kitasato University School of Medicine , Sagamihara , Japan
| | - D Saito
- Kitasato University School of Medicine , Sagamihara , Japan
| | - G Matsuura
- Kitasato University School of Medicine , Sagamihara , Japan
| | - T Sato
- Kitasato University School of Medicine , Sagamihara , Japan
| | - S Kobayashi
- Kitasato University School of Medicine , Sagamihara , Japan
| | - H Nakamura
- Kitasato University School of Medicine , Sagamihara , Japan
| | - J Oikawa
- Kitasato University School of Medicine , Sagamihara , Japan
| | - J Kishihara
- Kitasato University School of Medicine , Sagamihara , Japan
| | - H Fukaya
- Kitasato University School of Medicine , Sagamihara , Japan
| | - S Niwano
- Kitasato University School of Medicine , Sagamihara , Japan
| | - J Ako
- Kitasato University School of Medicine , Sagamihara , Japan
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Alejo A, Ahmed H, Krygier AG, Clarke R, Freeman RR, Fuchs J, Green A, Green JS, Jung D, Kleinschmidt A, Morrison JT, Najmudin Z, Nakamura H, Norreys P, Notley M, Oliver M, Roth M, Vassura L, Zepf M, Borghesi M, Kar S. Stabilized Radiation Pressure Acceleration and Neutron Generation in Ultrathin Deuterated Foils. Phys Rev Lett 2022; 129:114801. [PMID: 36154426 DOI: 10.1103/physrevlett.129.114801] [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: 01/26/2021] [Revised: 03/09/2022] [Accepted: 04/28/2022] [Indexed: 06/16/2023]
Abstract
Premature relativistic transparency of ultrathin, laser-irradiated targets is recognized as an obstacle to achieving a stable radiation pressure acceleration in the "light sail" (LS) mode. Experimental data, corroborated by 2D PIC simulations, show that a few-nm thick overcoat surface layer of high Z material significantly improves ion bunching at high energies during the acceleration. This is diagnosed by simultaneous ion and neutron spectroscopy following irradiation of deuterated plastic targets. In particular, copious and directional neutron production (significantly larger than for other in-target schemes) arises, under optimal parameters, as a signature of plasma layer integrity during the acceleration.
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Affiliation(s)
- A Alejo
- School of Mathematics and Physics, Queen's University Belfast, Belfast, BT7 1NN, United Kingdom
- Instituto Galego de Física de Altas Enerxías, Universidade de Santiago de Compostela, Santiago de Compostela 15782, Spain
| | - H Ahmed
- School of Mathematics and Physics, Queen's University Belfast, Belfast, BT7 1NN, United Kingdom
- Central Laser Facility, Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - A G Krygier
- Department of Physics, The Ohio State University, Columbus, Ohio 43210, USA
| | - R Clarke
- Central Laser Facility, Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - R R Freeman
- Department of Physics, The Ohio State University, Columbus, Ohio 43210, USA
| | - J Fuchs
- LULI-CNRS, CEA, UPMC Univ Paris 06: Sorbonne Université, Ecole Polytechnique, Institut Polytechnique de Paris, F-91128 Palaiseau cedex, France
| | - A Green
- School of Mathematics and Physics, Queen's University Belfast, Belfast, BT7 1NN, United Kingdom
| | - J S Green
- Central Laser Facility, Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - D Jung
- School of Mathematics and Physics, Queen's University Belfast, Belfast, BT7 1NN, United Kingdom
| | - A Kleinschmidt
- Institut für Kernphysik, TU Darmstadt, D-64289 Darmstadt, Germany
| | - J T Morrison
- Propulsion Systems Directorate, Air Force Research Lab, Wright Patterson Air Force Base, Ohio 45433, USA
| | - Z Najmudin
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, SW7 2AZ, United Kingdom
| | - H Nakamura
- The John Adams Institute for Accelerator Science, Blackett Laboratory, Imperial College London, SW7 2AZ, United Kingdom
| | - P Norreys
- Central Laser Facility, Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
- Department of Physics, University of Oxford, Oxford OX1 3PU, United Kingdom
| | - M Notley
- Central Laser Facility, Rutherford Appleton Laboratory, Didcot, Oxfordshire OX11 0QX, United Kingdom
| | - M Oliver
- Department of Physics, University of Oxford, Oxford OX1 3PU, United Kingdom
| | - M Roth
- Institut für Kernphysik, TU Darmstadt, D-64289 Darmstadt, Germany
| | - L Vassura
- LULI-CNRS, CEA, UPMC Univ Paris 06: Sorbonne Université, Ecole Polytechnique, Institut Polytechnique de Paris, F-91128 Palaiseau cedex, France
| | - M Zepf
- School of Mathematics and Physics, Queen's University Belfast, Belfast, BT7 1NN, United Kingdom
| | - M Borghesi
- School of Mathematics and Physics, Queen's University Belfast, Belfast, BT7 1NN, United Kingdom
| | - S Kar
- School of Mathematics and Physics, Queen's University Belfast, Belfast, BT7 1NN, United Kingdom
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Shalehin N, Seki Y, Takebe H, Fujii S, Mizoguchi T, Nakamura H, Yoshiba N, Yoshiba K, Iijima M, Shimo T, Irie K, Hosoya A. Gli1 +-PDL Cells Contribute to Alveolar Bone Homeostasis and Regeneration. J Dent Res 2022; 101:1537-1543. [PMID: 35786034 DOI: 10.1177/00220345221106921] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
The periodontal ligament (PDL) contains mesenchymal stem cells (MSCs) that can differentiate into osteoblasts, cementoblasts, and fibroblasts. Nevertheless, the distribution and characteristics of these cells remain uncertain. Gli1, an essential hedgehog signaling transcription factor, functions in undifferentiated cells during embryogenesis. Therefore, in the present study, the differentiation ability of Gli1+ cells was examined using Gli1-CreERT2/ROSA26-loxP-stop-loxP-tdTomato (iGli1/Tomato) mice. In 4-wk-old iGli1/Tomato mice, Gli1/Tomato+ cells were only slightly detected in the PDL, around endomucin-expressing blood vessels. These cells had proliferated over time, localizing in the PDL as well as on the bone and cementum surfaces at day 28. However, in 8-wk-old iGli1/Tomato mice, Gli1/Tomato+ cells were quiescent, as most cells were not immunoreactive for Ki-67. These cells in 8-wk-old mice exhibited high colony-forming unit fibroblast activity and were capable of osteogenic, chondrogenic, and adipogenic differentiation in vitro. In addition, after transplantation of teeth of iGli1/Tomato mice into the hypodermis of wild-type mice, Tomato fluorescence indicating the progeny of Gli1+ cells was detected in the osteoblasts and osteocytes of the regenerated bone. These results demonstrate that Gli1+ cells in the PDL were MSCs and could contribute to the alveolar bone regeneration.
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Affiliation(s)
- N Shalehin
- Division of Histology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - Y Seki
- Division of Histology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan.,Division of Orthodontics and Dentofacial Orthopedics, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - H Takebe
- Division of Histology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - S Fujii
- Division of Oral Surgery, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - T Mizoguchi
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - H Nakamura
- Department of Oral Anatomy, Matsumoto Dental University, Nagano, Japan
| | - N Yoshiba
- Division of Cariology, Department of Oral Health Science, Operative Dentistry and Endodontics, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - K Yoshiba
- Division of Oral Science for Health Promotion, Department of Oral Health and Welfare, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - M Iijima
- Division of Orthodontics and Dentofacial Orthopedics, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - T Shimo
- Division of Oral Surgery, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - K Irie
- Division of Anatomy, Department of Oral Growth and Development, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
| | - A Hosoya
- Division of Histology, School of Dentistry, Health Sciences University of Hokkaido, Ishikari-Tobetsu, Hokkaido, Japan
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Ghosh S, Kumar M, Santiana M, Mishra A, Zhang M, Labayo H, Chibly AM, Nakamura H, Tanaka T, Henderson W, Lewis E, Voss O, Su Y, Belkaid Y, Chiorini JA, Hoffman MP, Altan-Bonnet N. Enteric viruses replicate in salivary glands and infect through saliva. Nature 2022; 607:345-350. [PMID: 35768512 PMCID: PMC9243862 DOI: 10.1038/s41586-022-04895-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 05/23/2022] [Indexed: 12/22/2022]
Abstract
Enteric viruses like norovirus, rotavirus and astrovirus have long been accepted as spreading in the population through fecal-oral transmission: viruses are shed into feces from one host and enter the oral cavity of another, bypassing salivary glands (SGs) and reaching the intestines to replicate, be shed in feces and repeat the transmission cycle1. Yet there are viruses (for example, rabies) that infect the SGs2,3, making the oral cavity one site of replication and saliva one conduit of transmission. Here we report that enteric viruses productively and persistently infect SGs, reaching titres comparable to those in the intestines. We demonstrate that enteric viruses get released into the saliva, identifying a second route of viral transmission. This is particularly significant for infected infants, whose saliva directly transmits enteric viruses to their mothers' mammary glands through backflow during suckling. This sidesteps the conventional gut-mammary axis route4 and leads to a rapid surge in maternal milk secretory IgA antibodies5,6. Lastly, we show that SG-derived spheroids7 and cell lines8 can replicate and propagate enteric viruses, generating a scalable and manageable system of production. Collectively, our research uncovers a new transmission route for enteric viruses with implications for therapeutics, diagnostics and importantly sanitation measures to prevent spread through saliva.
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Affiliation(s)
- S Ghosh
- Laboratory of Host-Pathogen Dynamics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - M Kumar
- Laboratory of Host-Pathogen Dynamics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - M Santiana
- Laboratory of Host-Pathogen Dynamics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - A Mishra
- Laboratory of Host-Pathogen Dynamics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - M Zhang
- Laboratory of Host-Pathogen Dynamics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - H Labayo
- Laboratory of Host-Pathogen Dynamics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - A M Chibly
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - H Nakamura
- AAV Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - T Tanaka
- AAV Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - W Henderson
- Faculty of Nursing, University of Connecticut, Storrs, CT, USA
| | - E Lewis
- Metaorganism Immunity Section, Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- Microbiome Program, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - O Voss
- Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Y Su
- Advanced Imaging and Microscopy Resource, National Institutes of Health, Bethesda, MD, USA
- Laboratory of High Resolution Optical Imaging, National Institute of Biomedical Imaging and Bioengineering, National Institutes of Health, Bethesda, MD, USA
| | - Y Belkaid
- Metaorganism Immunity Section, Laboratory of Host Immunity and Microbiome, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
- Microbiome Program, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - J A Chiorini
- AAV Biology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - M P Hoffman
- Matrix and Morphogenesis Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - N Altan-Bonnet
- Laboratory of Host-Pathogen Dynamics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
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Natsume A, Arakawa Y, Narita Y, Sugiyama K, Hata N, Muragaki Y, Shinojima N, Kumabe T, Saito R, Motomura K, Mineharu Y, Miyakita Y, Yamasaki F, Matsushita Y, Ichimura K, Ito K, Tachibana M, Kakurai Y, Okamoto N, Asahi T, Nishijima S, Yamaguchi T, Tsubouchi H, Nakamura H, Nishikawa R. The first-in-human phase I study of a brain-penetrant mutant IDH1 inhibitor DS-1001 in patients with recurrent or progressive IDH1-mutant gliomas. Neuro Oncol 2022; 25:326-336. [PMID: 35722822 PMCID: PMC9925696 DOI: 10.1093/neuonc/noac155] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [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: 02/22/2022] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Approximately 70% of lower-grade gliomas harbor isocitrate dehydrogenase 1 (IDH1) mutations, resulting in the accumulation of oncometabolite D-2-hydroxyglutarate (D-2-HG); this leads to epigenetic dysregulation, oncogenesis, and subsequent clonal expansion. DS-1001 is an oral brain-penetrant mutant IDH1 selective inhibitor. This first-in-human study investigated the safety, pharmacokinetics, pharmacodynamics, and efficacy of DS-1001. METHODS This was a multicenter, open-label, dose-escalation, phase I study of DS-1001 for recurrent/progressive IDH1-mutant (R132) glioma (N = 47) (NCT03030066). DS-1001 was administered orally at 125-1400 mg twice daily. Dose-escalation used a modified continual reassessment method. RESULTS The maximum tolerated dose was not reached. Eight patients were continuing treatment at the data cutoff. Most adverse events (AEs) were grade 1-2. Twenty patients (42.6%) experienced at least 1 grade 3 AE. No grade 4 or 5 AEs or serious drug-related AEs were reported. Common AEs (>20%) were skin hyperpigmentation, diarrhea, pruritus, alopecia, arthralgia, nausea, headache, rash, and dry skin. The objective response rates were 17.1% for enhancing tumors and 33.3% for non-enhancing tumors. Median progression-free survival was 10.4 months (95% confidence interval [CI], 6.1 to 17.7 months) and not reached (95% CI, 24.1 to not reached) for the enhancing and non-enhancing glioma cohorts, respectively. Seven on-treatment brain tumor samples showed a significantly lower amount of D-2-HG compared with pre-study archived samples. CONCLUSIONS DS-1001 was well tolerated with a favorable brain distribution. Recurrent/progressive IDH1-mutant glioma patients responded to treatment. A study of DS-1001 in patients with chemotherapy- and radiotherapy-naïve IDH1-mutated WHO grade 2 glioma is ongoing (NCT04458272).
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Affiliation(s)
- Atsushi Natsume
- Corresponding Author: Atsushi Natsume, MD, PhD, The Institute of Innovation for Future Society, Nagoya University, NIC Room 803, Furo-Cho, Chikusa-Ku, Nagoya 464-8601, Japan ()
| | | | | | | | - Nobuhiro Hata
- Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Muragaki
- Graduate School of Medicine, Tokyo Women’s Medical University, Tokyo, Japan
| | | | | | - Ryuta Saito
- Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | - Yohei Mineharu
- Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | - Hideo Nakamura
- Department of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Ryo Nishikawa
- Saitama Medical University International Medical Center, Hidaka, Japan
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Anno S, Okano T, Mandai K, Orita K, Yamada Y, Mamoto K, Iida T, Tada M, Inui K, Koike T, Nakamura H. POS0681 DRUG RETENTION RATE AND EFFECTIVENESS OF JAK INHIBITOR IN PATIENTS WITH DIFFICULT-TO-TREAT RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundRecently, the disease activity of rheumatoid arthritis (RA) was improved due to the ‘treat-to-target’ strategy. However, some patients remain various symptoms despite recommended treatment was performed. Then, the term of ‘difficult-to-treat RA (D2TRA)’ is widely recognized. Janus kinase inhibitor (JAKi) might be effective for D2TRA patients, because JAKi can simultaneously block the function of multiple cytokines.ObjectivesThe aim of this study was to evaluate drug retention rate and effectiveness of JAKi in patients with D2TRA.MethodsThis study included 220 RA patients (tofacitinib 101, baricitinib 83, upadacitinib 20, peficitinib 14, filgotinib 2) treated with JAKi. Sixty-two patients were treated as first line bDMARDs/JAKi (1st group), 57 patients were treated as second line bDMARDs/ JAKi (2nd group), 101 patients were treated as third and more bDMARDs/ JAKi. In these 101 patients, 25 patients did not met D2TRA criteria (non-D2TRA group) and 76 patients met D2TRA criteria (D2TRA group). Drug retention rate and effectiveness of JAKi were evaluated during 24 weeks in each group.ResultsUsage rate of methotrexate was lower and dosage of glucocorticoid was higher in D2TRA group than in other groups (Table 1). Drug retention rate at 24 weeks was 87.1% (54/62) in 1st group, 80.1% (46/57) in 2nd group, 88% (22/25) in non-D2TRA group, 61.8% (47/76) in D2TRA group. Drug retention rate was lower in D2TRA group compared to 1st group, 2nd group and non-DT2RA group (p<0.01, p=0.03, p=0.01). DAS28-CRP was 4.4, 4.0, 3.9, 4.4 at baseline, 3.0, 3.0, 3.3, 3.5 at 4 weeks, 2.5, 2.9, 2.7, 3.3 at 12 weeks, 2.5, 3.0, 2.9, 3.2 at 24 weeks in 1st group, 2nd group, non-D2TRA group and D2TRA group, respectively. Improvement ratio of DAS28-CRP was 32.9, 27.6, 20.4, 19.3 % at 4 weeks, 40.8, 26.5, 28.1, 19.5 % at 12 weeks, 40.8, 24.6, 18.7, 24.7 % at 24 weeks. DAS28-CRP was improved in all groups. Altough 1st group showed higher improvement ratio of DAS28-CRP at 24 weeks compared to 2nd group, non-DT2RA group and D2TRA group (p<0.01, p<0.01, p<0.01), there was no differences between DT2RA group and 2nd group or non-D2TRA group (p=0.95, p=0.48). SDAI was 22.9, 19.9, 18.3, 23.9 at baseline, 11.8, 11.9, 13.3, 14.4 at 4 weeks, 7.9, 11.3, 8.4, 13.3 at 12 weeks, 8.5, 11.5, 9.7, 12.6 at 24 weeks. CDAI was 21.3, 18.8, 17.6, 21.8 at baseline, 11.3, 11.2, 12.5, 13.9 at 4 weeks, 7.5, 10.9, 8.0, 12.3 at 12 weeks, 8.1, 10.7, 8.6, 12.1 at 24 weeks. HAQ was 1.15, 0.99, 0.89, 1.39 at baseline, 0.84, 0.76, 0.93, 1.22 at 4 weeks, 0.79, 0.84, 0.77, 1.17 at 12 weeks, 0.76, 0.79, 0.76, 1.14 at 24 weeks. Improvement rate of HAQ at 24 weeks were 44.3%, 23.9%, 21.2%, 8.1%.Table 1.Baseline characteristics of RA patients1st group (n=62)2nd group (n=57)non-D2TRA group (n=25)D2TRA group (n=76)Age (years)64.9 ± 14.866.1 ± 11.564.6 ± 16.163.0 ± 15.0Female (%)75.879.096.080.3Disease durations (years)10.4 ± 11.717.6 ± 17.622.6 ± 22.416.3 ± 15.7RF (IU/ml)296.3 ± 1153.8314.9 ± 1037.7262.4 ± 375.9305.9 ± 819.6RF positive ratio (%)81.878.479.275.7Anti CCP antibody (U/ml)221.8 ± 327.2157.8 ± 258.795.9 ± 101.6191.8 ± 250.6Anti CCP antibody positive ratio (%)79.679.672.283.3CRP (U/ml)1.5 ± 2.11.1 ± 2.01.6 ± 1.61.8 ± 2.9MMP-3 (ng/ml)185.7 ± 167.6146.7 ± 122.1190.1 ± 152.6268.0 ± 451.2DAS28-CRP4.3 ± 1.24.1 ± 1.33.9 ± 1.44.4 ± 1.3SDAI21.8 ± 12.221.7 ± 13.118.4 ± 13.023.9 ± 12.8CDAI20.3 ± 11.320.7 ± 12.717.6 ± 12.822.1 ± 12.2HAQ1.1 ± 0.81.2 ± 1.00.9 ± 0.81.4 ± 1.1MTX use (%)69.463.25647.4MTX (mg/day)10.7 ± 3.410.4 ± 3.58.8 ± 3.59.0 ± 4.3Glucocorticoid use (%)29.136.81646.1Glucocorticoid dose (mg/day)3.3 ± 2.13.0 ± 1.53.5 ± 1.95.1 ± 2.8ConclusionDrug retention rate of JAKi in treatment of D2TRA group were lower than that of 1st group, 2nd group, and non-D2TRA group. Clinical efficacy of JAKi in D2TRA group were not significantly different to 2nd group and non-D2TRA group. However, HAQ improvement was weak in D2TRA group.Disclosure of InterestsNone declared
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Okano T, Mamoto K, Yamada Y, Mandai K, Anno S, Tada M, Inui K, Koike T, Nakamura H. AB0188 ULTRASONOGRAPHIC RESIDUAL INTRA-ARTICULAR SYNOVITIS IS MORE SEVERE IN RHEUMATOID ARTHRITIS PATIENTS TREATED WITH PREDNISOLONE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundThe treatment option including biological DMARDs (BIO) and JAK inhibitor (JAK) was expanded, and the number of patients reached to the treatment target are increasing in rheumatoid arthritis (RA). On the other hand, it is also true that some patients are still using prednisolone (PSL). Recently, ultrasound has played a role of sensitive imaging modality in the diagnosis and follow-up of patients with RA. It is known that residual synovitis was found in ultrasound even in patients with clinical remission.ObjectivesWe investigated the differences of ultrasonographic intra-articular synovitis findings between treatment drugs in patients with RA.MethodsFrom January 2017 to August 2020, 750 RA patients who underwent ultrasound examination were included. A US examination was performed at the bilateral first to fifth metacarpophalangeal (MCP) joints, first interphalangeal (IP) and second to fifth proximal interphalangeal (PIP) joints, wrist joints (three part of radial, medial and ulnar) and first to fifth metatarsophalangeal (MTP) joints, by using HI VISION Ascendus (Hitachi Medical Corporation, Japan) with a multifrequency linear transducer (18-6 MHz). The gray scale and power Doppler findings were assessed by the semi-quantitative method (0-3). All patients were divided into with or without BIO / JAK, methotrexate (MTX) and PSL. Then, patients were matched using the propensity score adjusted for gender, age, RA disease duration, disease activity, CRP value, and MMP-3 value. The total gray scale and power Doppler score (GSUS / PDUS) were compared between treatment drugs of RA by using propensity score matching methods.ResultsThe average age of 750 RA patients were 64.5 years and an average disease duration of RA was 13.9 years and females were 581 (77.5%). There were 517 patients (68.9%) treated with BIO/JAK and 233 patients treated without BIO/JAK. The 205 patients in each group were matched. GSUS were 10.6±11.1 vs 9.2±10.4 (p=0.218) and PDUS 7.4±9.2 vs 6.5±9.0 (p=0.328). Ultrasound residual synovitis was not different between with or without BIO/JAK in matched patients. There were 525 patients (70.0%) treated MTX, the average MTX dose was 9.3 mg, and 225 patients treated without MTX. The 203 patients with or without MTX in each group were matched. GSUS were 9.7±10.6 vs 11.4±12.0 (p=0.119) and PDUS 6.6±8.8 vs 8.1±10.1 (p=0.117). Ultrasound residual synovitis was not different between with or without MTX in matched patients. There were 111 patients (14.8%) treated PSL, the average dose was 4.0mg, and 639 patients treated without PSL. The 105 patients with or without PSL in each group were matched. GSUS were 15.7±13.9 vs 11.6±10.6 (p=0.018) and PDUS 11.5±11.4 vs 8.1±9.6 (p=0.021). Ultrasound residual synovitis was more severe treated with PSL than without PSL in matched patients.ConclusionIn a comparison between RA patients matched backgrounds such as disease activity, there was no difference in ultrasound residual synovitis between patients with or without BIO/JAK and MTX. However, there was significant difference in patients with or without PSL. This suggests that PSL use suppresses clinical symptoms but does not improve synovitis. Thus, it should be noted that joint destruction may progress in patients treating with PSL.References[1]Grassi W, Okano T, Di Geso L, Filippucci E. Imaging in rheumatoid arthritis: options, uses and optimization. Expert Rev Clin Immunol. 2015;11:1131-46.[2]Nguyen H, Ruyssen-Witrand A, Gandjbakhch F, Constantin A, Foltz V, Cantagrel A. Prevalence of ultrasound-detected residual synovitis and risk of relapse and structural progression in rheumatoid arthritis patients in clinical remission: a systematic review and meta-analysis. Rheumatology (Oxford). 2014;53:2110-8.AcknowledgementsWe wish to thank Atsuko Kamiyama, Tomoko Nishimura for clinical assistant, Setsuko Takeda, Emi Yamashita, Yuko Yoshida, Emi Ohtani, Yuka Domae, Asami Yagami, Shingo Washida for their special efforts as a sonographer and collecting data.Disclosure of InterestsTadashi Okano Speakers bureau: Asahi Kasei, Astellas, Abbvie, Amgen, Ayumi, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead Sciences, Janssen, Kyowa Kirin, Mitsubishi Tanabe, Novartis, Ono, Pfizer, Sanofi, Takeda, UCB, Grant/research support from: Asahi Kasei, Abbvie, Chugai, Eisai, Mitsubishi Tanabe, Kenji Mamoto: None declared, Yutaro Yamada: None declared, Koji Mandai: None declared, Shohei Anno: None declared, Masahiro Tada: None declared, Kentaro Inui Speakers bureau: Daiichi Sankyo Co. Ltd., Mitsubishi Tanabe Pharma, Janssen Pharmaceutical K.K., Astellas Pharma Inc., Takeda Pharmaceutical Co. Ltd., Ono Pharmaceutical Co. Ltd., Abbvie GK, Pfizer Inc., Eisai Co.,Ltd., Chugai Pharmaceutical Co., Ltd., Grant/research support from: Janssen Pharmaceutical K.K., Astellas Pharma Inc., Sanofi K.K., Abbvie GK, Takeda Pharmaceutical Co. Ltd., QOL RD Co. Ltd., Mitsubishi Tanabe Pharma, Ono Pharmaceutical Co. Ltd., Eisai Co.,Ltd.,, Tatsuya Koike Speakers bureau: Takeda Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, Chugai Pharmaceutical, Eisai, Abbott Japan, Teijin Pharma, Banyu Pharmaceutical and Ono Pharmaceutical, Hiroaki Nakamura: None declared
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Yamada Y, Okano T, Mamoto K, Inui K, Mandai K, Koike T, Nakamura H. AB0340 SHORTENING THE DOSING INTERVAL OR DOSE ESCALATION OF BIOLOGICAL DMARDs SUPPRESSED RESIDUAL ULTRASOUND SYNOVITIS AND JOINT DESTRUCTION IN PATIENTS WITH RHEUMATOID ARTHRITIS -STARBOARD STUDY-. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundIn patients with rheumatoid arthritis (RA) who have residual synovitis even after using biological disease modified anti-rheumatic drug (bDMARDs), joint destruction may progress1,. The enhanced treatment such as shortening the dosing interval or dose escalation of bDMARDs are recommended for these patients, if allowed in package inserts 2, 3.ObjectivesWe investigated the effects of enhanced treatment in RA patients with residual synovitis under treatment with standard dose of bDMARDs.MethodsForty RA patients treated with standard dose of infliximab, tocilizumab or golimumab were included in this study. Ultrasound (US) examination was performed at the bilateral first to fifth metacarpophalangeal (MCP) joints, first interphalangeal (IP) and second to fifth proximal interphalangeal (PIP) joints, wrist joints (three parts of radial, medial and ulnar) and first to fifth metatarsophalangeal (MTP) joints, by using HI VISION Ascendus (Hitachi Medical Corporation, Japan) with a multifrequency linear transducer (18-6 MHz). Residual synovitis was defined as Power Doppler score (PD) ≥2. In patients with residual synovitis, we recommended enhanced treatment. The patients were divided into 3 groups, PD≥2/ET+ group (patients agreed enhanced treatment), PD≥2/ET- group (patients rejected enhanced treatment), and PD<2 group. We assessed ultrasound (PD score), laboratory data (CRP, MMP-3), disease activity (Simplified Disease Activity Index; SDAI), physical function (Health Assessment Questionnaire; HAQ), and joint destruction (modified Total Sharp Score; mTSS) at baseline and 1-year follow-up.ResultsThere were 9 patients in PD≥2/ET+ group and 31 patients in PD<2 group. PD≥2/ET+ group had significantly higher SDAI (p=0.027), MMP-3 (p=0.005), and PD (p<0.001) at baseline compared with PD<2 group, but their MMP-3 (p=0.019) and PD (p=0.042) were significantly decreased over 1 year. PD≥2/ET+ group had joint destruction before ET (p=0.022), but it was suppressed after ET and there was no significance in change in mTSS compared with PD<2 group (p>0.99) (Figure 1).Figure 1.Disease activity, ultrasound assessment and radiographic change from baseline (BL) to 1-year follow-up in RA patients with residual synovitis who had enhanced treatment (PD≥2/ET+) and those without active synovitis (PD<2).*Each parameter at BL and 1-year was statistically analyzed by Wilcoxin signed rank test only in PD≥2/ET+ group.**Difference in two groups at BL was statistically analyzed by Student t test or Mann-Whitney U test.SDAI: simplified disease activity index, HAQ: health assessment questionnaire, PD: Power Doppler, MMP-3: matrix metalloproteinase 3, mTSS: modified Total Sharp Score.ConclusionIn RA patients with the residual synovitis under treatment with standard dose of bDMARDs, enhanced treatment decreased the synovitis and suppressed the joint destruction.References[1]Nguyen H, Ruyssen-Witrand A, Gandjbakhch F, Constantin A, Foltz V, Cantagrel A. Prevalence of ultrasound-detected residual synovitis and risk of relapse and structural progression in rheumatoid arthritis patients in clinical remission: a systematic review and meta-analysis. Rheumatology (Oxford). 2014 Nov;53(11):2110-8.[2]Ogata A, Tanaka Y, Ishii T, Kaneko M, Miwa H, Ohsawa S; SHINOBI study group. A randomized, double-blind, parallel-group, phase III study of shortening the dosing interval of subcutaneous tocilizumab monotherapy in patients with rheumatoid arthritis and an inadequate response to subcutaneous tocilizumab every other week: Results of the 12-week double-blind period. Mod Rheumatol. 2018 Jan;28(1):76-84.[3]Takeuchi T, Miyasaka N, Tatsuki Y, Yano T, Yoshinari T, Abe T, Koike T. Baseline tumour necrosis factor alpha levels predict the necessity for dose escalation of infliximab therapy in patients with rheumatoid arthritis. Ann Rheum Dis. 2011 Jul;70(7):1208-15.Disclosure of InterestsNone declared
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Mamoto K, Koike T, Okano T, Sugioka Y, Tada M, Inui K, Nakamura H. AB0229 ACHIEVING GLUCOCORTICOID FREE MIGHT DECREASE RISK FOR CLINICAL FRACTURES IN PATIENTS WITH RHEUMATOID ARTHRITIS - TEN-YEAR FINDINGS FROM THE TOMORROW STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundPatients with rheumatoid arthritis (RA) who have muscle weakness and stiff or painful joints might be at increased risk of falls and fractures.ObjectivesThe present study prospectively investigates correlations between decreasing doses of glucocorticoid (GC) and the incidence of clinical fractures in patients with RA based on the ten-year findings of the TOMORROW study (UMIN000003876) that started in 2010.MethodsWe evaluated anthropometric parameters, bone mineral density, disease activity, RA medication, and the incidence of clinical fractures over a period of ten years in 202 patients with RA (mean age, 58.6 years; mean disease duration, 14.0 years). We also investigated the effects of GC doses on the incidence of clinical fractures over the same period in patients with RA using multivariate regression analysis.ResultsThe incidence of clinical fractures for ten years in patients with RA was 0.036/person-year. There were 89 patients (44.1%) treated with GC at least once during ten years. The incidences of clinical fractures in patients with RA treated with and without GC during ten years were 0.052 and 0.026/person-year, respectively. After adjusting for fracture risk factors including age, sex, smoking, and body mass index, cox proportional hazard model revealed that GC dose of ≥ 2 mg/day at baseline was a significant risk factor for clinical fractures (Hazard ratio [HR]:2.430; 95%CI, 1.040-5.675, p=0.040). Although the risk for clinical fractures did not decrease by just reducing the dose of GC (HR:4.505; 95%CI, 0.589-34.457, p=0.147), it was significantly lower if the dose of GC could be reduced to zero during ten years (HR:0.407; 95%CI, 0.194-0.857, p=0.018).ConclusionMedication with even low dose of GC are apparently significantly associated with an increased frequency of clinical fractures among patients with RA. However, if the dose of GC was reduced to free during ten years, the clinical fracture risk could become lower. We concluded that we should decrease the dose of GC to free after controlling disease activity of RA.Disclosure of InterestsNone declared
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Anno S, Okano T, Mandai K, Orita K, Yamada Y, Mamoto K, Iida T, Tada M, Inui K, Koike T, Nakamura H. POS0290 THE EFFECTS OF TREATMENT RESPONSE AND RISK FACTOR TO INHIBIT THE CLINICAL RESPONSE IN PATIENTS WITH DIFFICULT-TO-TREAT RHEUMATOID ARTHRITIS TREATED WITH IL-6 RECEPTOR INHIBITOR, ABATACEPT AND JAK INHIBITOR. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundRecently, the disease activity of rheumatoid arthritis (RA) was improved due to the ‘treat-to-target’ strategy. However, some patients remain various symptoms despite recommended treatment was performed. Then, the term of ‘difficult-to-treat RA (D2TRA)’ is widely recognized. It is unknown how the difference of type of biological disease-modifying anti rheumatic dugs (bDMARDs)/Janus kinase inhibitor (JAKi) will affect clinical efficacy in patients with D2TRA. Moreover, the risk factor to inhibit the clinical response in patients with D2TRA is unknown.ObjectivesThe aim of this study was to evaluate the treatment response in patients with D2TRA who were treated with interleukin 6 receptor inhibitor (IL-6Ri), abatacept and JAKi.MethodsThis study used the multicenter database included 673 RA patients treated with bDMARDs/JAKi (tocilizumab 240, sarilumab 67, abatacept 146, tofacitinib 101, baricitinib 83, upadacitinib 20, peficitinib 14, filgotinib 2). Two hundred forty-two patients were treated as first line bDMARDs/JAKi (IL-6Ri 117, abatacept 63, JAKi 62), 211 patients were treated as second line bDMARDs/JAKi (IL-6Ri 117, abatacept 37, JAKi 57), 220 patients were treated as third and more bDMARDs/JAKi. In these 220 patients, 82 patients did not meet D2TRA criteria (IL-6Ri 42, abatacept 15, JAKi 25) and 138 patients met D2TRA criteria (IL-6Ri 31, abatacept 31, JAKi 76). In all patients, we analyzed 138 patients with D2TRA (113 female, mean age was 63.1 ± 13.7 years). Drug retention rate and effectiveness of bDMARDs/JAKi in patients with D2TRA were evaluated for 24 weeks. Multivariate linear regression analysis was performed to clarify the risk factors to inhibit the clinical response.ResultsDrug retention rate of patients with D2TRA at 24 weeks was 67.7% in IL-6Ri group, 74.2% in abatacept group, 61.8% in JAKi group. Drug retention rate in patients with D2TRA was not different between groups (IL-6Ri vs abatacept: p=0.86, IL-6Ri vs JAKi group: p=0.39, abatacept vs JAKi group: p=0.33). DAS28-CRP at 4, 12, 24 weeks decreased in all group (Figure 1). Abatacept showed lower improvement ratio of DAS28-CRP at 24 weeks compared to IL-6Ri group (IL-6Ri vs abatacept: p<0.01, IL-6Ri vs JAKi: p=0.1, abatacept vs JAKi: p=0.07). Good responder (defined as decrease in DAS28-CRP score > 1.2 with a score < 3.2) was 52.4% patients in IL-6Ri, 17.4% patients in abatacept, 29.8% patients in JAKi. SDAI and CDAI at 4, 12, 24 weeks decreased in all group (Figure 1). There were no diferences between the groups in improvement ratio of SDAI (IL-6Ri vs abatacept: p=0.11, IL-6Ri vs JAKi: p=0.81, abatacept vs JAKi: p=0.08) and CDAI (IL-6Ri vs abatacept: p=0.31, IL-6Ri vs JAKi: p=0.82, abatacept vs JAKi: p=0.13) at 24 weeks. HAQ was 1.42, 1.15, 1.39 at baseline, 1.27, 1.07, 1.22 at 4 weeks, 1.17, 1.07, 1.17 at 12 weeks, 1.26, 1.06, 1.14 at 24 weeks in IL-6Ri group, abatacept and JAKi, respectively. Multivariate linear regression analysis revealed that high HAQ (β=0.28, p=0.02) and high dosage of glucocorticoid (β=0.67, p<0.01) inhibited the improvement of DAS28-CRP. Type of bDMARDs/JAKi (β=-0.09, p=0.36) did not affect the DAS28-CRP improvement for 24 weeks.Table 1.Multivariate linear regression analysis of risk factor to inhibit the clinical response in patients with D2TRA.β95% CIpAge (years)-0.037-0.025, 0.0170.74male-0.047-0.788, 0.4860.64Disease durations (years)-0.048-0.028, 0.0170.63RF (IU/ml)-0.082-0.0004, 0.00020.41Anti CCP antibody (U/ml)0.111-0.0005, 0.0020.26DAS28-CRP-0.063-0.265, 0.1420.55HAQ0.2790.059, 0.7170.02MTX (mg/day)0.136-0.018, 0.0810.21Glucocorticoid dose (mg/day)0.6690.174, 0.324< 0.01Type of bDMARDs/JAKi-0.088-0.415, 0.1510.36ConclusionDrug retention rate and clinical efficacy of D2TRA patients were not different among IL-6Ri, abatacept and JAKi. DT2RA patient with functional disorder and high dosage of glucocorticoid were risk factor to inhibit the clinical response.Disclosure of InterestsNone declared
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Mamoto K, Koike T, Okano T, Sugioka Y, Tada M, Inui K, Nakamura H. AB0225 FRAX ASSESSMENT IN PATIENTS WITH RHEUMATOID ARTHRITIS PREDICTED THE REAL INCIDENCE OF CLINICAL FRACTURES FOR 10 YEARS FROM THE RESULTS OF THE 10-YEAR TOMORROW STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundTo investigate if FRAX in patients with RA can predict the incidence of new clinical fractures for 10 years by using the 10-year data of the TOMORROW study (UMIN000003876) which is a prospective cohort study.ObjectivesTo investigate if FRAX in patients with RA can predict the incidence of new clinical fractures for 10 years by using the 10-year data of the TOMORROW study (UMIN000003876) which is a prospective cohort study.MethodsWe calculated ten-year probability of major osteoporotic fracture (FRAX) in 208 RA patients and 205 sex- and age-matched volunteers (Vo), and compared FRAX with the incidence of clinical fractures for 10 years.ResultsThe mean FRAX were 14.5 and 8.8% in 175 RA patients and 168 Vo, respectively, in whom we could calculate FRAX at baseline and complete to investigate the incidence of clinical fractures for 10 years from baseline. The mean FRAX in RA patients was significantly higher than that in Vo (P<0.001). The actual incidence of clinical fractures for 10 years in RA patients was significantly higher than that in Vo (33.9 vs 22.9%, P=0.031). In both groups, the actual incidence of clinical fractures was higher than FRAX prediction. Logistic regression analysis revealed that FRAX and FRAX≧15% were the significant risk factors for clinical fractures for 10 years in both groups (Odds ratio (OR), 1.055, P<0.001, 2.943, P=0.043, respectively). The mean FRAX in RA patients with and without clinical fractures for 10 years were 18.5 and 12.5%, respectively (P=0.002). In RA patients, FRAX was also the significant risk factor for clinical fractures (OR, 1.046, P=0.004).ConclusionFRAX and the incidence of clinical fractures for 10 years were significantly higher in RA patients than them of Vo. We confirmed that FRAX was the risk factor for clinical fractures in actual clinical practice.Disclosure of InterestsNone declared
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Okano T, Koike T, Inui K, Tada M, Mamoto K, Yamada Y, Orita K, Mandai K, Anno S, Iida T, Nakamura H. AB0405 JAK INHIBITORS IMPROVE PATIENT-REPORTED OUTCOMES SUCH AS PAIN AND HAQ EARLIER THAN ANTI-IL-6 INHIBITORS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.3024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundClinical feature of Janus kinase (JAK) inhibitor is recognized as not only suppress inflammation but also improve patient-reported outcomes (PRO) such as pain and health assessment questioner (HAQ) in patients with rheumatoid arthritis (RA). This representative clinical feature was known as a results of phase 3 trial compared to TNF inhibitor. One of the mechanisms of JAK in RA is to suppresses interleikin-6 (IL-6). However, the effect for PRO in JAK inhibitor compared to IL-6 inhibitor have not been known.ObjectivesWe investigated the effect for patient-reported outcomes such as pain and HAQ in patients with RA treated with JAK inhibitor compared to IL-6 inhibitor.MethodsThis study was analysed a multicenter database included RA patients treated with biological disease-modifying anti rheumatic dugs (bDMARDs) and JAK inhibitors. In 307 patients treated with IL-6 inhibitor (tocilizumab 240 and sarilumab 67) and 220 patients with JAK inhibitor (tofacitinib 101, baricitinib 83, upadacitinib 20, peficitinib 14 and filgotinib 2), 155 patients were treated as first-line bDMARDs/JAK inhibitor (IL-6R inhibitor 104 and JAK inhibitor 51). In this first-line patients, patients treated with IL-6R inhibitor and JAK inhibitor were matched using the propensity score adjusted for gender, age, RA disease duration, baseline charactristics of disease activity, CRP level, and MMP-3 level. The beaseline data and the change of clinical and laboratory data at 4, 12 and 24 weeks were compared between IL-6 inhibitor and JAK inhibitor.ResultsThirty-six patients in each group were matched and analyzed. The average age was 62.4 and 62.6 years and the average disease duration of RA was 13.2 and 10.1 years in IL-6 inhibitor and JAK inhibitor. The baseline characteristics were not significantly different in both groups. At week 4, tender joint count (TJC) was significantly improved in JAK inhibitor than IL-6 (IL-6: -1.86 vs JAK: -4.12, p= 0.036) and HAQ was significantly improved in JAK inhibitor than IL-6 (IL-6: -0.04 vs JAK: -0.27, p= 0.041). Moreover, Clinical Disease Activity Index (CDAI) was also improved in JAK inhibitor than IL-6 (IL-6: -6.6 vs JAK: -10.9, p= 0.026) at week 4. However, pain VAS and patient global VAS were not significantly different in each group in week4. TJC, HAQ and CDAI was not different in both groups at week 12 and week 24. On the other hand, ESR was significantly decreased in IL-6 inhibitor than JAK inhibitor at week 4, 12 and 24 (IL-6: -26.6 vs JAK: -14.1, p=0.018 at week 4, IL-6: -32.7 vs JAK: -16.5 p=0.004 at week 12, IL-6: -31.3vs JAK: -17.7 p=0.014 at week 24).ConclusionIn a comparison between IL-6 inhibitor and JAK inhibitor as a first-line molecular-targeted drug matched baseline charactristics of disease activity, TJC and HAQ was improved in JAK inhibitor earlier than IL-6 inhibitors. JAK inhibitor suppress multi cytokine that might be the reason why JAK inhibitor improve pain. Improvement of patient reported outcome in JAK inhibitor was found also in comparison with IL-6 inhibitor.References[1]Taylor PC, Keystone EC, van der Heijde D, et al. Baricitinib versus Placebo or Adalimumab in Rheumatoid Arthritis. N Engl J Med. 2017;376:652-62.[2]Fleischmann R, Pangan AL, Song IH, et al. Upadacitinib Versus Placebo or Adalimumab in Patients with Rheumatoid Arthritis and an Inadequate Response to Methotrexate: Results of a Phase III, Double-Blind, Randomized Controlled Trial. Arthritis Rheumatol. 2019;71:1788-1800.AcknowledgementsWe wish to thank Atsuko Kamiyama and Tomoko Nishimura for clinical assistant, and all member of Team RA.Disclosure of InterestsTadashi Okano Speakers bureau: Asahi Kasei, Astellas, Abbvie, Amgen, Ayumi, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Gilead Sciences, Janssen, Kyowa Kirin, Mitsubishi Tanabe, Novartis, Ono, Pfizer, Sanofi, Takeda, UCB, Grant/research support from: Asahi Kasei, Abbvie, Chugai, Eisai, Mitsubishi Tanabe, Tatsuya Koike Speakers bureau: Takeda Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, Chugai Pharmaceutical, Eisai, Abbott Japan, Teijin Pharma, Banyu Pharmaceutical and Ono Pharmaceutical, Kentaro Inui Speakers bureau: Daiichi Sankyo Co. Ltd., Mitsubishi Tanabe Pharma, Janssen Pharmaceutical K.K., Astellas Pharma Inc., Takeda Pharmaceutical Co. Ltd., Ono Pharmaceutical Co. Ltd., Abbvie GK, Pfizer Inc., Eisai Co.,Ltd., Chugai Pharmaceutical Co., Ltd., Grant/research support from: Janssen Pharmaceutical K.K., Astellas Pharma Inc., Sanofi K.K., Abbvie GK, Takeda Pharmaceutical Co. Ltd., QOL RD Co. Ltd., Mitsubishi Tanabe Pharma, Ono Pharmaceutical Co. Ltd., Eisai Co.,Ltd., Masahiro Tada: None declared, Kenji Mamoto: None declared, Yutaro Yamada: None declared, kazuki Orita: None declared, Koji Mandai: None declared, Shohei Anno: None declared, Takahiro Iida: None declared, Hiroaki Nakamura: None declared
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Yamada Y, Tada M, Mandai K, Hidaka N, Nakamura H. AB0262 PATIENTS WITH RHEUMATOID ARTHRITIS WHO DEVELOP SARCOPENIA FALL FREQUENTLY: 5-YEAR DATA FROM THE CHIKARA STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundPatients with rheumatoid arthritis (RA) are likely to have sarcopenia due to decreased muscle mass and physical function. Some patients develop sarcopenia even if disease activity is well-controlled. We previously reported that 13.2% of RA patients without sarcopenia at baseline developed sarcopenia over a year1.ObjectivesThe aim was to longitudinally investigate sarcopenia status and the characteristics of RA patients using data from the prospective, observational CHIKARA study.MethodsBody composition, laboratory data, disease activity, physical function (HAQ), treatment, and history of falls and fractures were investigated in 100 RA patients who participated in the CHIKARA study at baseline and at 5 years. They were divided into 4 groups depending on their sarcopenia status: no sarcopenia developed (N group; sarcopenia absent at baseline and 5 years); sarcopenia developed (S group; sarcopenia absent at baseline, but present at 5 years); cured (C group; sarcopenia present at baseline, but absent at 5 years); and persistent (P group; sarcopenia present at baseline and at 5 years).ResultsSeventy RA patients completed the survey. There were no differences among the 4 groups in disease activity, physical function, and treatment. The N group, accounting for 67.1% of all patients, was young and had high body mass index, muscle mass, fat mass, estimated bone mass, and body metabolic rate at baseline. On the other hand, the S group, accounting for 4.3% of all patients, fell significantly more frequently (p=0.035), 3.3 times during 5 years. The P group, accounting for 18.6% of all patients, had significantly higher MMP-3 at baseline (p=0.006). The C group accounted for 10.0% of all patients (Table 1).Table 1.Characteristics of 77 RA patients by sarcopenia status at baseline and at 5-year follow-upno development (n=47)development (n=3)cured (n=7)persisted (n=13)p valueage, years63 (57.5, 70)76 (74.5, 81)66 (54, 70)73 (65, 82)0.006disease duration, years6.5 (1.1, 10.7)15.2 (14.9, 20.7)11.4 (7.2, 14.8)3.5 (1.1, 6.5)0.021MTX dose, mg/day8.1 ± 3.76.0 ± 2.07.4 ± 3.86.2 ± 4.80.406biologics use, %36.266.728.623.10.513GC use, %23.4028.615.40.701average GC dose, mg/day3.5 ± 1.103.7 ± 1.86.3 ± 1.80.833CRP, mg/dl0.1 (0.04, 0.18)0.04 (0.04, 0.23)0.2 (0.12, 0.47)0.19 (0.08,0.82)0.22MMP-3, ng/ml62.2 (50.3, 98.6)58.9 (47.8, 71.3)74.9 (58.3,147.2)160 (90.8,262)0.006DAS28ESR3.34 ± 0.914.11 ± 0.723.36 ± 1.383.79 ± 1.200.355mHAQ0.25 (0, 0.5)0.63 (0.56, 1.25)0.87 (0.25, 1.0)0.25 (0.13, 0.75)0.132BMI, kg/m223.22 ± 3.5121.4 ± 2.2518.69 ± 2.0819.56 ± 2.39<0.001SMI, kg/m26.73 ± 0.76.1 ± 0.25.51 ± 0.145.79 ± 0.6<0.001fat percentage, %30.39 ± 8.7730.03 ± 9.1225.04 ± 6.2323.75 ± 6.560.051estimated bone mass, kg2.2 (2, 2.4)1.9 (1.75, 1.95)1.6 (1.55, 1.9)1.9 (1.7, 2.2)0.001BMR, kcal1101 (1051, 1198)986 (934, 1010)896 (872, 994)978 (902,1107)<0.001ΔDAS28ESR-0.15 ± 0.84-0.43 ± 1.730.04 ± 0.89-0.59 ± 1.330.445ΔSMI, kg/m2-0.06 ± 0.34-0.38 ± 0.570.25 ± 0.220.08 ± 0.420.038fall, times1.63.331.290.380.045Data are shown as mean ± standard deviation (SD) or median (25th, 75th percentile).GC: glucocorticoids, MMP-3: matrix metalloproteinase 3, DAS: disease activity score, HAQ: health assessment questionnaire, BMI: body mass index, SMI: skeletal muscle mass index, BMR: body metabolization rate, Δ:change during 5 years.ConclusionOverall, 4.3% of RA patients developed sarcopenia and fell frequently during 5-year follow-up. Patients who develop sarcopenia require special care because they are at high risk of falls.References[1]Y Yamada, M Tada, K Mandai et al. Glucocorticoid use is an independent risk factor for developing sarcopenia in patients with rheumatoid arthritis: from the CHIKARA study. Clin Rheumatol 2020 Jun;39(6):1757-1764.Disclosure of InterestsNone declared
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Anno S, Iida T, Yamada Y, Okano T, Sugioka Y, Inui K, Wakitani S, Nakamura H. POS1146 ROMOSOZUMAB INCREASE BONE MINERAL DENSITY AT LUMBAR AND FEMORAL IRRESPECTIVE OF PREOSTEOPOROSIS TREATMENT, HISTORY OF FRAGILITY FRACTURE AND COMBINATION OF VITAMIN D. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundRomosozumab, a monoclonal antibody that binds sclerostin, increases bone formation and decreases bone resorption. Romosozumab has an excellent therapeutic effect on patients with osteoporosis. However, there are few reports investigated the efficacy and the effect of various factors relative to osteoporosis in real-world.ObjectivesWe evaluated bone mineral density (BMD) and bone metabolism marker (BMM) change in osteoporosis patients treated with romosozumab, and assessed the effect of various factors, such as preosteoporosis treatment, history of fragility fracture and combination of vitamin D.MethodsThis study included 141 osteoporosis patients (132 female, mean age: 78.8 ± 7.5 years, mean hight: 151.1 ± 7.5 cm, mean weight: 50.9 ± 8.9 kg) treated with romosozumab. BMD measurements using dual energy X-ray absorptiometry (DXA) and BMM measurements using N-terminal propeptide of type 1 collagen (P1NP) were evaluated at 0, 4, 6, and 12 months after treatment. DXA were performed at the lumbar spine (n=92), at proximal femoral and femoral neck (n=92), and at distal third radius (n=49). We evaluated the influence of preosteoporosis treatment, history of fragility fracture and combination of vitamin D for BMD change.ResultsBMD at lumbar spine (5.2%: p<0.01, 9.2%: p<0.01, 10.8%: p<0.01), proximal femoral (1.3%: p=0.02, 2.8%: p<0.01, 4.5%: p<0.01) and femoral neck (2.0%: p=0.03, 2.7%: p=0.06, 5.0%: p=0.01) were significantly increased at 4, 8, 12 months after treatment. BMD at distal third radius (-1.5%: p<0.01, -0.8%: p=0.17, -1.0%: p=0.13) were not increased at 4, 8, 12 months after treatment. P1NP chane were 63% (p<0.01), 6.4% (p=0.55), -2.3% (p=0.2) at 4, 8, 12 months after treatment. There were no significant differences in 1 year improvement ratio of BMD at lumbar spine, proximal femoral and femoral neck between 38 patients with pretreatment of osteoporosis and 54 patients without pretreatment of osteoporpsis (13.5 vs 9.5%: p=0.1, 4.9 vs 4.4%: p=0.7, 6.1 vs 4.6%: p=0.67), between 33 patients with a history of fragility fracture and 59 patients without a history of fragility fracture (7.3 vs 11.7%: p=0.42, 0.8 vs 5.5%: p=0.08, -0.7 vs 6.6%: p=0.14), between 50 patients with romosozumab alone and 42 patients with romosozumab plus vitamin D (11.3 vs 10.0%: p=0.93, 4.1 vs 5.3%: p=0.59, 6.8 vs 2.3%: p=0.47). There were no significant differences in 1 year improvement ratio of BMD at distal third radius between 33 patients with pretreatment of osteoporosis and 16 patients without pretreatment of osteoporpsis (-1.1 vs -0.9%: p=0.63), between 31 patients with a history of fragility fracture and 18 patients without a history of fragility fracture (-1.5 vs -0.5%: p=0.3).ConclusionRomosozumab improved BMD at lumbar and femoral independently regardless of preosteoporosis treatment, history of fragility fracture and combination of vitamin D.References[1]Felicia Cosman et al. Romosozumab Treatment in Postmenopausal Women with Osteoporosis. N Engl J Med 2016; 375:1532-1543, DOI: 10.1056/NEJMoa1607948Disclosure of InterestsNone declared
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Yoshimura C, Koike T, Mamoto K, Okano T, Sugioka Y, Tada M, Inui K, Nakamura H. POS0631 EVEN LOW-DOSE GLUCOCORTICOID USE IS A RISK FACTOR FOR CLINICAL FRACTURES IN PATIENTS WITH RHEUMATOID ARTHRITIS: TEN-YEAR FINDINGS OF THE TOMORROW STUDY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.4573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPatients with rheumatoid arthritis (RA) who have sarcopenia and stiff or painful joints might be at increased risk of falls and fractures.ObjectivesThe present study aimed to prospectively identify the incidence of clinical fractures and associated risk factors in patients with RA in a cohort study named the TOMORROW (UMIN000003876) that started in 2010.MethodsWe evaluated anthropometric parameters, bone mineral density (BMD), disease activity, RA medication at entry and observed the incidence of clinical fractures during ten years in 202 patients with RA (mean age, 58.6 y; medication with biological agents, 54.9%) and 202 age- and sex-matched non-RA volunteers (Vo) (mean age, 57.4 y). We compared the incidence of clinical fractures between patients with RA and Vo for ten years, and analyzed the risk factors for clinical fractures using Cox proportional hazard model.ResultsThe incidences of clinical fractures were 0.036 and 0.024/person-year in patients with RA and Vo, respectively. Cox proportional hazard model revealed that low BMD at the thoracic vertebrae (< 0.7 g/cm2) and history of fractures at entry were significantly associated with the incidence of clinical fractures (Hazard ratio [HR]1.737, p=0.020 and HR1.514, p=0.047, respectively) in all participants. RA morbidity, however, was not (HR1.398, p=0.112). In patients with RA, medication with GC at entry was a significant risk factor for clinical fractures (HR1.898, p=0.017). Additionally, a mean GC dose (≥ 2 mg/day) at entry and during the ten-year period increased risk for fractures (HR 2.189, p=0.004, 1.866, p=0.022, respectively).ConclusionRA per se was not a risk factor for clinical fractures in this cohort. Low BMD at the thoracic vertebrae at entry and the use of GC with even low dose at entry and during ten years were significantly associated with an increased frequency of clinical fractures among patients with RA.Disclosure of InterestsNone declared
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Takami H, Nakamura H, Ichimura K, Nishikawa R. Still divergent but on the way to convergence: clinical practice of CNS germ cell tumors in Europe and North America from the perspectives of the East. Neurooncol Adv 2022; 4:vdac061. [PMID: 35611272 PMCID: PMC9122787 DOI: 10.1093/noajnl/vdac061] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- Hirokazu Takami
- Department of Neurosurgery, The University of Tokyo Hospital
| | - Hideo Nakamura
- Department of Neurosurgery, Kurume University School of Medicine
| | - Koichi Ichimura
- Department of Brain Disease Translational Research, Juntendo University Faculty of Medicine
| | - Ryo Nishikawa
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center
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Takami H, Satomi K, Fukuoka K, Matsushita Y, Yamasaki K, Nakamura T, Kanamori M, Tominaga T, Tanaka S, Mukasa A, Saito N, Suzuki T, Yanagisawa T, Nakamura H, Sakai K, Sugiyama K, Tamura K, Maehara T, Nakada M, Nonaka M, Asai A, Yokogami K, Takeshima H, Iuchi T, Kanemura Y, Kobayashi K, Nagane M, Kurozumi K, Yoshimoto K, Matsuda M, Matsumura A, Hirose Y, Tokuyama T, Kumabe T, Narita Y, Shibui S, Nakazato Y, Nishikawa R, Matsutani M, Ichimura K. BOT-3 Prognostic Factors of CNS Germ Cell Tumors; Molecular and Histopathological Analyses on 154 Cases from the iGCT Consortium. Neurooncol Adv 2021. [PMCID: PMC8664686 DOI: 10.1093/noajnl/vdab159.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Germ cell tumors (GCTs) preferentially occurs in pediatric and young adult age groups. Chemo- and radiation therapies cause long-term sequelae in their later lives. We searched for clinical and histopathological features to predict the prognosis and affect treatment response, with a future goal of treatment stratification.Methods: A total of 154 GCT cases were included in the analysis. Total of 114 germinoma cases underwent measurement of tumor cell content on H-E specimen, and 82 GCT cases underwent 450K methylation analysis. 12p gain was determined on methylation-based copy number computation and FISH. Association with progression-free and overall survival (PFS/OS) was investigated. Results: The tumor cell content was widely distributed from <5% to 90% in the specimens, with a median value of 50%. Patients with a higher tumor cell content (>=50%) showed shorter PFS than those with a lower tumor cell content (<50 %) (p=0.03). In the multivariate analysis with tumor location, tumor cell content was the sole statistically significant prognostic factor (p=0.04). 12p gain was found in 25-out-of-82 cases (30%) and was more frequent in NGGCTs, particularly in cases with malignant components. The presence of 12p gain correlated with shorter PFS and OS, even with histology and tumor markers incorporated in the multivariate analysis. Among NGGCTs, 12p gain still had prognostic significance for PFS and OS. The 12p copy number status was shared among histological components in mixed GCTs. Whole-genome amplification was suggested by FISH.Conclusions: We found that tumor cell content significantly affected the prognosis of germinomas. 12p gain predicts the presence of malignant components of NGGCTs, and poor prognosis of the patients. Furthermore, 12p is likely to be an early event in the tumorigenesis of CNS GCT. These potentially open the possibility of leveraging these pathological and molecular factors in the future clinical trials when stratifying the treatment intensity.
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Affiliation(s)
- Hirokazu Takami
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute
| | - Kaishi Satomi
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute
- Division of Pediatric Neuro-Oncology, Saitama Medical University International Medical Center
| | - Kohei Fukuoka
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute
- Division of Pediatric Neuro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Yuko Matsushita
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute
- Department of Neurosurgery and Neuro-oncology, National Cancer Center Hospital, Tokyo, Japan
- Department of Brain Disease Translational Research, Juntendo University Faculty of Medicine, Tokyo, Japan
| | - Kai Yamasaki
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute
- Department of Pediatrics, Osaka City General Hospital, Osaka, Japan
| | - Taishi Nakamura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute
- Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Kanagawa, Japan
| | - Masayuki Kanamori
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Miyagi, Japan
| | - Shota Tanaka
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Tomonari Suzuki
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Takaaki Yanagisawa
- Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hideo Nakamura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Department of Neurosurgery, Kurume University, Fukuoka, Japan
| | - Keiichi Sakai
- Department of Neurosurgery, Shinshu Ueda Medical Center, Nagano, Japan
| | - Kazuhiko Sugiyama
- Department of Neurosurgery, Hiroshima University Faculty of Medicine, Hiroshima, Japan
| | - Kaoru Tamura
- Department of Neurosurgery, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Taketoshi Maehara
- Department of Neurosurgery, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Mitsutoshi Nakada
- Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan
| | - Masahiro Nonaka
- Department of Neurosurgery, Kansai Medical University Hospital, Osaka, Japan
| | - Akio Asai
- Department of Neurosurgery, Kansai Medical University Hospital, Osaka, Japan
| | - Kiyotaka Yokogami
- Department of Neurosurgery, University of Miyazaki Faculty of Medicine, Miyazaki, Japan
| | - Hideo Takeshima
- Department of Neurosurgery, University of Miyazaki Faculty of Medicine, Miyazaki, Japan
| | - Toshihiko Iuchi
- Department of Neurosurgery, Chiba Cancer Center, Chiba, Japan
| | - Yonehiro Kanemura
- Department of Biomedical Research and Innovation, Institute for Clinical Research, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Keiichi Kobayashi
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Motoo Nagane
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Kazuhiko Kurozumi
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan
- Department of Neurosurgery, Hamamatsu University Hospital, Shizuoka, Japan
| | - Koji Yoshimoto
- Department of Neurosurgery, Kyusyu University Hospital, Fukuoka, Japan
| | - Masahide Matsuda
- Department of Neurosurgery, University of Tsukuba Hospital, Ibaraki, Japan
| | - Akira Matsumura
- Department of Neurosurgery, University of Tsukuba Hospital, Ibaraki, Japan
| | - Yuichi Hirose
- Department of Neurosurgery, Fujita Health University Hospital, Aichi, Japan
| | - Tsutomu Tokuyama
- Department of Neurosurgery, Hamamatsu University Hospital, Shizuoka, Japan
- Department of Neurosurgery, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Toshihiro Kumabe
- Department of Neurosurgery, Kitasato University, Kanagawa, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Soichiro Shibui
- Department of Neurosurgery and Neuro-oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Ryo Nishikawa
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Masao Matsutani
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute
- Department of Brain Disease Translational Research, Juntendo University Faculty of Medicine, Tokyo, Japan
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Komaki S, Furuta T, Negoto T, Moritsubo M, Nakamura H, Sugita Y, Morioka M. CS-7 A case of Lymphomatoid granulomatosis with skin, lung, and intracranial lesions due to multicentric development. Neurooncol Adv 2021. [PMCID: PMC8648174 DOI: 10.1093/noajnl/vdab159.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: LYG is very rare tumor and composed of large EB-positive B cells and reactive T cells. In this study, we experienced a case of LYG with multiple intracranial, cutaneous, and pulmonary masses. We report the pathogenesis and pathophysiology of LYG, including a discussion of the literature. case: A 69-year-old female presented with a growing lump in her lower back that had been present for several years. Six months later, she was found to have multiple masses in her lungs and intracranial region and underwent surgical removal for diagnostic purposes. Intraoperative findings: The tumor was substantial, reddish to grayish-white in color, and the margins of the tumor were whitish and hard, with some areas that could not be detached. Pathological findings: There were no atypical lymphocytes, and a small number of EBER-positive cells were observed. IgVH PCR: IgVH PCR was performed on the skin lesions and intracranial lesions, and bands of different sizes were detected, suggesting that the IgVH clone was present in the polyclonal region. Finally, we diagnosed LYG grade 1. discussion: EB-associated lymphoproliferative disease can lead to polyclonal reactive growth or monoclonal neoplastic growth depending on the balance between morphology and host immunity. The results of IgVH PCR suggest that the skin lesions did not cause multiple metastases, but rather that the enlargement of the skin lesions triggered intracranial and pulmonary lesions in an allo-centric manner. The results of IgVH PCR suggested that the skin lesions did not cause multiple metastases, but rather that the skin lesions grew to cause intracranial and pulmonary involvement in an other-centric manner.
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Affiliation(s)
- Satoru Komaki
- Departments of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Takuya Furuta
- Departments of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Tetsuya Negoto
- Departments of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Mayuko Moritsubo
- Departments of Pathology, Kurume University School of Medicine, Fukuoka, Japan
| | - Hideo Nakamura
- Departments of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Yasuo Sugita
- Departments of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
| | - Motohiro Morioka
- Departments of Neurosurgery, Kurume University School of Medicine, Fukuoka, Japan
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Nakamura H, Yanagisawa T, Soejima T, Yokoo H, Nishikawa R, Fujimaki T, Hara J, Terashima K, Sonoda Y, Arakawa Y, Kumabe T, Sugiyama K, Fukuoka K, Takami H, Sakurada K, Mineharu Y, Fujii M, Shinojima N, Yamasaki K, Fujimura J, Yamasaki F, Takahashi M, Suzuki T, Sato I. PEDT-5 Problem for the guideline of CNS germ cell tumors. Neurooncol Adv 2021. [PMCID: PMC8648248 DOI: 10.1093/noajnl/vdab159.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Primary CNS germ cell tumors (GCTs) are rare neoplasms, therefore, a clinical guideline has not been established so far. While better management has been achieved over recent decades by modifying radiation coverage and selecting appropriate chemotherapy, standardization of treatment remains challenging, partly due to the low volume of cases encountered in each institution. As the incidence is higher in East Asia, including Japan, the Japan Society for Neuro-Oncology established a multidisciplinary task force to create an evidence-based guideline for CNS GCTs. The Medical Information Network Distribution Service (Minds) guideline was referred to and utilized in the course of creating this guideline. We chose 6 topics and 10 clinical questions. This guideline provides recommendations for multiple dimensions of clinical management for CNS GCTs, with particular focus on diagnostic measures including serum markers, treatment algorithms including surgery, radiotherapy and chemotherapy, and under-investigated but important areas such as treatment for recurrent cases, long-term follow-up protocols and long-term sequelae. International collaborations to set standards of clinical management for this rare tumor have proven fruitful, concurrently, many fields continue to show variance in clinical practice, partly due to the rarity of clinical encounters and the absence of documented standards. There still seem to be differences in the treatment concept between Japan and North America or Europe countries. This guideline serves the purpose of helping healthcare professionals keep up to date with current knowledge and standards of management for patients with this rare disease in daily clinical practice, as well as driving future translational and clinical research by recognizing unmet needs concerning this tumor. We discuss about the issues both already clarified and should be cleared in the future.
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Affiliation(s)
- Hideo Nakamura
- Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan
| | | | | | - Hideaki Yokoo
- Department of Human Pathology, Gunma University Graduate School of Medicine
| | - Ryo Nishikawa
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center
| | | | - Junichi Hara
- Department of Pediatric Hematology and Oncology, Osaka City General Hospital
| | - Keita Terashima
- Division of Neuro-Oncology, National Center for Child Health and Development
| | | | - Yoshiki Arakawa
- Department of Neurosurgery, Kyoto University Graduate School of Medicine
| | - Toshihiro Kumabe
- Department of Neurosurgery, Kitasato University School of Medicine
| | - Kazuhiko Sugiyama
- Department of Clinical Oncology and Neuro-Oncology Program, Hiroshima University Hospital
| | - Kohei Fukuoka
- Department of Hematology and Oncology, Saitama Children’s Medical Center
| | - Hirokazu Takami
- Department of Neurosurgery, The University of Tokyo Hospital
| | - Kaori Sakurada
- Department of Neurosurgery, Yamagata University Hospital
| | - Yohei Mineharu
- Department of Neurosurgery, Kyoto University Graduate School of Medicine
| | - Motoaki Fujii
- JSNO Working Group for the guideline of CNS germ cell tumors
| | - Naoki Shinojima
- JSNO Working Group for the guideline of CNS germ cell tumors
| | - Kai Yamasaki
- JSNO Working Group for the guideline of CNS germ cell tumors
| | - Junya Fujimura
- JSNO Working Group for the guideline of CNS germ cell tumors
| | | | - Mayu Takahashi
- JSNO Working Group for the guideline of CNS germ cell tumors
| | - Tomonari Suzuki
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center
| | - Iori Sato
- JSNO Working Group for the guideline of CNS germ cell tumors
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Negoto T, Komaki S, Moritsubo M, Furuta T, Nakamura H, Morioka M. COT-9 Prognostic impact of hypercoagulation in glioblastoma and molecular mechanism thereof. Neurooncol Adv 2021. [PMCID: PMC8648236 DOI: 10.1093/noajnl/vdab159.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Introduction: Pathological features of glioblastoma include intravascular thrombosis, suggesting that the thrombus formation in tumor microenvironment contributes to progression of gliomas. Meanwhile, glioblastoma has been known to be high risk malignant tumor for venous thromboembolism, however, it remains unclear how the coagulation-fibrinolysis system is disrupted, which essentially grow within the cranium in a localized manner, and how the disruption contributes to the malignant transformation. Methods: Total 64 patients with glioblastoma between January 2014 and April 2021 who underwent a D-dimer test before the therapeutic intervention were divided into two groups: the high D-dimer group (D-dimer level >3.0μg/ml) and the low D-dimer group (D-dimer level <3.0μg/ml). We compared the two groups in the maximum gadolinium-enhanced MRI lesions, MIB-1 index, and gene abnormalities (IDH mutation, TERT promoter mutation, and MGMT promotor methylation). The progression-free survival (PFS) and overall survival were analyzed using the Kaplan-Meier method. Furthermore, in 23 patients who underwent a D-dimer test at recurrence, the time to death after recurrence was analyzed. Results: The PFS in high D-dimer group was significantly shorter than that in the low D-dimer group (log-rank p = 0.0075). The D-dimer increase at the time of recurrence significantly correlated with the decrease in post-recurrence survival duration (log-rank p = 0.0226). Moreover, the gadolinium-enhanced lesions in the high D-dimer group were significantly larger. Conclusion: The Pre-intervention D-dimer levels and PFS suggest that glioblastoma-induced systemic enhancement of the coagulation-fibrinolysis system plays a role in the malignant transformation. The D-dimer increase during the treatment was found to be a predictor of poor prognosis after recurrence. Furthermore, the MRI findings revealed a correlation between the D-dimer increase and the size of intratumoral necrosis. Meanwhile, no correlation with the MIB-1 index was found, suggesting that the mechanism of malignant transformation by hypercoagulation differ from enhanced cell proliferation.
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Affiliation(s)
- Tetsuya Negoto
- Department of Neurosurgery, Kurume University School of Medicine
| | - Satoru Komaki
- Department of Neurosurgery, Kurume University School of Medicine
| | | | - Takuya Furuta
- Department of Pathology, Kurume University School of Medicine
| | - Hideo Nakamura
- Department of Neurosurgery, Kurume University School of Medicine
| | - Motohiro Morioka
- Department of Neurosurgery, Kurume University School of Medicine
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Takahashi M, Okada K, Ouch R, Konno T, Usui K, Suzuki H, Satoh M, Kogure T, Satoh K, Watanabe Y, Nakamura H, Murai Y. Fibronectin plays a major role in hypoxia-induced lenvatinib resistance in hepatocellular carcinoma PLC/PRF/5 cells. Pharmazie 2021; 76:594-601. [PMID: 34986955 DOI: 10.1691/ph.2021.1854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Resistance to lenvatinib mesylate (LEN), a systemic chemotherapy that can be administered orally, has been a major issue for treatment of hepatocellular carcinoma (HCC). Although HCC is the tumor that most exhibits intratumoral hypoxia, which has been shown to be involved in the development of treatment resistance, there are no reports of LEN resistance in HCC treatment under hypoxia. The purpose of our study was to elucidate the mechanism of treatment resistance to LEN under hypoxia using HCC cell lines. We confirmed LEN resistance under hypoxic conditions in HCC cell lines. There was a significant increase in the IC50 value of PLC/PRF/5 cells from 13.0±0.8 μM in normoxia to 21.3±1.1 μM in hypoxia, but in HepG2 cells, the increase was not significant. To elucidate the LEN resistance mechanism of PLC/PRF/5 cells under hypoxia, we performed microarray analysis and extracted genes that are thought to be related to this mechanism. Furthermore, in-silico analysis confirmed significant changes in the extracellular matrix, and among them, FN1 encoding fibronectin was determined as the hub of the gene cluster. The expression of fibronectin in PLC/PRF/5 cells examined with immunofluorescence staining was significantly elevated in and outside of cells under hypoxia, and tended to decrease when cells were exposed to LEN under normoxia. Furthermore, the fibronectin concentration in the culture solution of PLC/PRF/5 cells examined by ELISA was 2.3 times higher under hypoxia than under normoxia under LEN(-) conditions, and 1.6 times higher under hypoxia than under normoxia under LEN(+) conditions. It is assumed that in PLC/PRF/5 cells, fibronectin is probably suppressed as an indirect effect of LEN under normoxia, but transcription factors such as HIF-1α are induced under hypoxia, thus enhancing the production of fibronectin and attenuating the effect of LEN, resulting in drug resistance. This behavior of fibronectin with LEN exposure under hypoxia is probably specific to PLC/PRF/5 cells. Further studies should verify the combined effective inhibition of fibronectin and the MAPK pathway as a promising therapeutic strategy to enhance the value of LEN in HCC treatment.
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Affiliation(s)
- M Takahashi
- Division of Clinical Pharmaceutics, Tohoku Medical and Pharmaceutical University; Miyagi, Japan; Department of Pharmacy, Tohoku Medical and Pharmaceutical University; Miyagi, Japan
| | - K Okada
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University; Miyagi, Japan; Division of Clinical Pharmaceutics and Pharmacy Practice, Tohoku Medical and Pharmaceutical University; Miyagi, Japan;,
| | - R Ouch
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University; Miyagi, Japan; Division of Clinical Pharmaceutics and Pharmacy Practice, Tohoku Medical and Pharmaceutical University; Miyagi, Japan
| | - T Konno
- Division of Clinical Pharmaceutics, Tohoku Medical and Pharmaceutical University; Miyagi, Japan; Department of Pharmacy, Tohoku Medical and Pharmaceutical University; Miyagi, Japan
| | - K Usui
- Department of Pharmacy, Tohoku Medical and Pharmaceutical University; Miyagi, Japan; Division of Clinical Pharmaceutics and Pharmacy Practice, Tohoku Medical and Pharmaceutical University; Miyagi, Japan
| | - H Suzuki
- Division of Clinical Pharmaceutics, Tohoku Medical and Pharmaceutical University; Miyagi, Japan; Department of Pharmacy, Tohoku Medical and Pharmaceutical University; Miyagi, Japan
| | - M Satoh
- Division of Gastroenterology, Tohoku Medical and Pharmaceutical University; Miyagi, Japan
| | - T Kogure
- Division of Gastroenterology, Tohoku Medical and Pharmaceutical University; Miyagi, Japan
| | - K Satoh
- Division of Gastroenterology, Tohoku Medical and Pharmaceutical University; Miyagi, Japan
| | - Y Watanabe
- Division of Clinical Pharmaceutics and Pharmacy Practice, Tohoku Medical and Pharmaceutical University; Miyagi, Japan
| | - H Nakamura
- Division of Clinical Pharmaceutics, Tohoku Medical and Pharmaceutical University; Miyagi, Japan
| | - Y Murai
- Division of Clinical Pharmaceutics, Tohoku Medical and Pharmaceutical University; Miyagi, Japan
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Nakamura H, Takami H, Yanagisawa T, Kumabe T, Fujimaki T, Arakawa Y, Karasawa K, Terashima K, Yokoo H, Fukuoka K, Sonoda Y, Sakurada K, Mineharu Y, Soejima T, Fujii M, Shinojima N, Hara J, Yamasaki K, Fujimura J, Yamasaki F, Takahashi M, Suzuki T, Sato I, Nishikawa R, Sugiyama K. The Japan Society for Neuro-Oncology Guideline on the Diagnosis and Treatment of Central Nervous System Germ Cell Tumors. Neuro Oncol 2021; 24:503-515. [PMID: 34671804 DOI: 10.1093/neuonc/noab242] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Primary CNS germ cell tumors (GCTs) are rare neoplasms predominantly observed in the pediatric and young adult populations. In line with the hypothesis that the primordial germ cell is the cell-of-origin, histopathological examinations for this pathology involve a diverse range of components mirroring the embryogenic developmental dimensions. Chemotherapy and radiotherapy are the mainstays of treatment, with surgery having a limited role for diagnosis and debulking of residual tissue after treatment. While better management has been achieved over recent decades by modifying radiation coverage and selecting appropriate chemotherapy, standardization of treatment remains challenging, partly due to the low volume of cases encountered in each institution. As the incidence is higher in East Asia, including Japan, the Japan Society for Neuro-Oncology established a multidisciplinary task force to create an evidence-based guideline for CNS GCTs. This guideline provides recommendations for multiple dimensions of clinical management for CNS GCTs, with particular focus on diagnostic measures including serum markers, treatment algorithms including surgery, radiotherapy and chemotherapy, and under-investigated but important areas such as treatment for recurrent cases, long-term follow-up protocols and long-term sequelae. This guideline serves the purpose of helping healthcare professionals keep up to date with current knowledge and standards of management for patients with this rare disease in daily clinical practice, as well as driving future translational and clinical research by recognizing unmet needs concerning this tumor.
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Affiliation(s)
- Hideo Nakamura
- Department of Neurosurgery, Kurume University School of Medicine
| | - Hirokazu Takami
- Department of Neurosurgery, The University of Tokyo Hospital
| | | | - Toshihiro Kumabe
- Department of Neurosurgery, Kitasato University School of Medicine
| | | | - Yoshiki Arakawa
- Department of Neurosurgery, Kyoto University Graduate School of Medicine
| | - Katsuyuki Karasawa
- Division of Radiation Oncology/Department of Radiology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital
| | - Keita Terashima
- Division of Neuro-Oncology, National Center for Child Health and Development
| | - Hideaki Yokoo
- Department of Human Pathology, Gunma University Graduate School of Medicine
| | - Kohei Fukuoka
- Department of Hematology and Oncology, Saitama Children's Medical Center
| | | | - Kaori Sakurada
- Department of Neurosurgery, Yamagata University Hospital
| | - Yohei Mineharu
- Department of Neurosurgery, Kyoto University Graduate School of Medicine
| | | | - Motoaki Fujii
- Department of Radiation Therapy, Mitsui Memorial Hospital
| | - Naoki Shinojima
- Department of Neurosurgery, Kumamoto University School of Medicine
| | - Junichi Hara
- Department of Pediatric Hematology and Oncology, Osaka City General Hospital
| | - Kai Yamasaki
- Department of Pediatric Hematology and Oncology, Osaka City General Hospital
| | - Junya Fujimura
- Department of Pediatrics, Juntendo University Faculty of Medicine
| | | | - Mayu Takahashi
- Department of Neurosurgery, University of Occupational and Environmental Health
| | - Tomonari Suzuki
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center
| | - Iori Sato
- Department of Family Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo
| | - Ryo Nishikawa
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center
| | - Kazuhiko Sugiyama
- Department of Clinical Oncology and Neuro-Oncology Program, Hiroshima University Hospital
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40
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Yoshioka W, Sonehara K, Iida A, Oya Y, Kurashige T, Okubo M, Ogawa M, Matsuda F, Higasa K, Mori-Yoshimura M, Nakamura H, Hayashi S, Okada Y, Noguchi S, Nishino I. DISTAL MYOPATHIES. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.099] [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: 11/28/2022]
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41
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Hama M, Horie R, Kubota T, Matsumura T, Kimura E, Nakamura H, Takahashi M, Takada H. MYOTONIC DYSTROPHY. Neuromuscul Disord 2021. [DOI: 10.1016/j.nmd.2021.07.258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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42
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Takami H, Satomi K, Fukuoka K, Fukushima S, Matsushita Y, Yamasaki K, Nakamura T, Tanaka S, Mukasa A, Saito N, Suzuki T, Yanagisawa T, Nakamura H, Sugiyama K, Tamura K, Maehara T, Nakada M, Nonaka M, Asai A, Yokogami K, Takeshima H, Iuchi T, Kanemura Y, Kobayashi K, Nagane M, Kurozumi K, Yoshimoto K, Matsuda M, Matsumura A, Hirose Y, Tokuyama T, Kumabe T, Narita Y, Shibui S, Nakazato Y, Nishikawa R, Matsutani M, Ichimura K. Low tumor cell content predicts favorable prognosis in germinoma patients. Neurooncol Adv 2021; 3:vdab110. [PMID: 34549182 PMCID: PMC8446917 DOI: 10.1093/noajnl/vdab110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Background Germinoma preferentially occurs in pediatric and young adult age groups. Although they are responsive to treatment with chemotherapy and radiation, the treatment may cause long-term sequelae in their later lives. Here, we searched for clinical and histopathological features to predict the prognosis of germinoma and affect treatment response. Methods A total of 114 germinoma cases were included in the analysis. We investigated the association between clinical factors, tumor cell content, and progression-free survival (PFS). Results The tumor cell content was widely distributed from <5% to 90% in the specimens, with a median value of 50%. Female patients showed higher tumor cell content in the specimens (P = .002). Cases with lesions at atypical sites showed shorter PFS than those with lesions at other sites (P = .03). Patients with a higher tumor cell content (≥50%) showed shorter PFS than those with a lower tumor cell content (<50%) (P = .03). In multivariate analysis, tumor cell content was the only statistically significant prognostic factor (P = .04). Among the 7 cases treated with local radiation and chemotherapy, all 3 cases that recurred (2 outside of the radiation field, 1 unknown) had tumor cell content of ≥50% in the original specimen, whereas all 4 cases without recurrence had tumor cell contents of <50%. Conclusions We found that tumor cell content significantly affected the prognosis of germinomas. Although validation of these results using an independent and larger cohort is necessary, this potentially opens the possibility of leveraging this pathological factor in future clinical trials when stratifying the treatment intensity.
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Affiliation(s)
- Hirokazu Takami
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Department of Neurosurgery, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Kaishi Satomi
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Kohei Fukuoka
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Division of Pediatric Neuro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan
| | - Shintaro Fukushima
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Matsushita
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Department of Neurosurgery and Neuro-oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Kai Yamasaki
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Department of Pediatrics, Osaka City General Hospital, Osaka, Japan
| | - Taishi Nakamura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan.,Department of Neurosurgery, Graduate School of Medicine, Yokohama City University, Kanagawa, Japan
| | - Shota Tanaka
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Akitake Mukasa
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan.,Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, Faculty of Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Tomonari Suzuki
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Takaaki Yanagisawa
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan.,Department of Neurosurgery, The Jikei University School of Medicine, Tokyo, Japan
| | - Hideo Nakamura
- Department of Neurosurgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.,Department of Neurosurgery, Kurume University, Fukuoka, Japan
| | - Kazuhiko Sugiyama
- Department of Neurosurgery, Hiroshima University Faculty of Medicine, Hiroshima, Japan
| | - Kaoru Tamura
- Department of Neurosurgery, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Taketoshi Maehara
- Department of Neurosurgery, Tokyo Medical and Dental University, Graduate School of Medical and Dental Sciences, Tokyo, Japan
| | - Mitsutoshi Nakada
- Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan
| | - Masahiro Nonaka
- Department of Neurosurgery, Kansai Medical University Hospital, Osaka, Japan
| | - Akio Asai
- Department of Neurosurgery, Kansai Medical University Hospital, Osaka, Japan
| | - Kiyotaka Yokogami
- Department of Neurosurgery, University of Miyazaki Faculty of Medicine, Miyazaki, Japan
| | - Hideo Takeshima
- Department of Neurosurgery, University of Miyazaki Faculty of Medicine, Miyazaki, Japan
| | - Toshihiko Iuchi
- Department of Neurosurgery, Chiba Cancer Center, Chiba, Japan
| | - Yonehiro Kanemura
- Department of Neurosurgery, National Hospital Organization Osaka National Hospital, Osaka, Japan.,Department of Biomedical Research and Innovation, Institute for Clinical Research, National Hospital Organization Osaka National Hospital, Osaka, Japan
| | - Keiichi Kobayashi
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Motoo Nagane
- Department of Neurosurgery, Kyorin University Faculty of Medicine, Tokyo, Japan
| | - Kazuhiko Kurozumi
- Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.,Department of Neurosurgery, Hamamatsu University Hospital, Shizuoka, Japan
| | - Koji Yoshimoto
- Department of Neurosurgery, Kyusyu University Hospital, Fukuoka, Japan
| | - Masahide Matsuda
- Department of Neurosurgery, University of Tsukuba Hospital, Ibaraki, Japan
| | - Akira Matsumura
- Department of Neurosurgery, University of Tsukuba Hospital, Ibaraki, Japan
| | - Yuichi Hirose
- Department of Neurosurgery, Fujita Health University Hospital, Aichi, Japan
| | - Tsutomu Tokuyama
- Department of Neurosurgery, Hamamatsu University Hospital, Shizuoka, Japan.,Department of Neurosurgery, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan
| | - Toshihiro Kumabe
- Department of Neurosurgery, Kitasato University, Kanagawa, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Soichiro Shibui
- Department of Neurosurgery and Neuro-oncology, National Cancer Center Hospital, Tokyo, Japan
| | | | - Ryo Nishikawa
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Masao Matsutani
- Department of Neuro-Oncology/Neurosurgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Koichi Ichimura
- Division of Brain Tumor Translational Research, National Cancer Center Research Institute, Tokyo, Japan
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Aoki K, Suzuki H, Yamamoto T, Yamamoto KN, Maeda S, Okuno Y, Ranjit M, Motomura K, Ohka F, Tanahashi K, Hirano M, Nishikawa T, Shimizu H, Kitano Y, Yamaguchi J, Yamazaki S, Nakamura H, Takahashi M, Narita Y, Nakada M, Deguchi S, Mizoguchi M, Momii Y, Muragaki Y, Abe T, Akimoto J, Wakabayashi T, Saito R, Ogawa S, Haeno H, Natsume A. Mathematical Modeling and Mutational Analysis Reveal Optimal Therapy to Prevent Malignant Transformation in Grade II IDH-Mutant Gliomas. Cancer Res 2021; 81:4861-4873. [PMID: 34333454 PMCID: PMC9635454 DOI: 10.1158/0008-5472.can-21-0985] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/10/2021] [Accepted: 07/23/2021] [Indexed: 01/07/2023]
Abstract
Isocitrate dehydrogenase-mutant low-grade gliomas (IDHmut-LGG) grow slowly but frequently undergo malignant transformation, which eventually leads to premature death. Chemotherapy and radiotherapy treatments prolong survival, but can also induce genetic (or epigenetic) alterations involved in transformation. Here, we developed a mathematical model of tumor progression based on serial tumor volume data and treatment history of 276 IDHmut-LGGs classified by chromosome 1p/19q codeletion (IDHmut/1p19qcodel and IDHmut/1p19qnoncodel) and performed genome-wide mutational analyses, including targeted sequencing and longitudinal whole-exome sequencing data. These analyses showed that tumor mutational burden correlated positively with malignant transformation rate, and chemotherapy and radiotherapy significantly suppressed tumor growth but increased malignant transformation rate per cell by 1.8 to 2.8 times compared with before treatment. This model revealed that prompt adjuvant chemoradiotherapy prolonged malignant transformation-free survival in small IDHmut-LGGs (≤ 50 cm3). Furthermore, optimal treatment differed according to genetic alterations for large IDHmut-LGGs (> 50 cm3); adjuvant therapies delayed malignant transformation in IDHmut/1p19qnoncodel but often accelerated it in IDHmut/1p19qcodel. Notably, PI3K mutation was not associated with malignant transformation but increased net postoperative proliferation rate and decreased malignant transformation-free survival, prompting the need for adjuvant therapy in IDHmut/1p19qcodel. Overall, this model uncovered therapeutic strategies that could prevent malignant transformation and, consequently, improve overall survival in patients with IDHmut-LGGs. SIGNIFICANCE: A mathematical model successfully estimates malignant transformation-free survival and reveals a link between genetic alterations and progression, identifying precision medicine approaches for optimal treatment of IDH-mutant low-grade gliomas.
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Affiliation(s)
- Kosuke Aoki
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan.,Institute of Nano-Life-Systems, Institutes of Innovation for Future Society, Nagoya University, Nagoya, Aichi, Japan.,Corresponding Authors: Kosuke Aoki, Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya 4668550, Japan. Phone: 815-2744-2353; E-mail: ; Hiroshi Haeno, ; and Atsushi Natsume,
| | - Hiromichi Suzuki
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Takashi Yamamoto
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Kimiyo N. Yamamoto
- Departments of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki-shi, Osaka, Japan
| | - Sachi Maeda
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Yusuke Okuno
- Medical Genomics Center, Nagoya University Hospital, Nagoya, Aichi, Japan.,Department of Virology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Aichi, Japan
| | - Melissa Ranjit
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Kazuya Motomura
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Fumiharu Ohka
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Kuniaki Tanahashi
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Masaki Hirano
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Tomohide Nishikawa
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Hiroyuki Shimizu
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Yotaro Kitano
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Junya Yamaguchi
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Shintaro Yamazaki
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Hideo Nakamura
- Department of Neurosurgery, Kumamoto University, Kumamoto, Japan.,Department of Neurosurgery, Kurume University, Kurume, Fukuoka, Japan
| | - Masamichi Takahashi
- Department of Neurosurgery and Neuro-oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yoshitaka Narita
- Department of Neurosurgery and Neuro-oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Mitsutoshi Nakada
- Department of Neurosurgery, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Shoichi Deguchi
- Division of Neurosurgery, Shizuoka Cancer Center Hospital, Shizuoka, Japan
| | - Masahiro Mizoguchi
- Department of Neurosurgery, Graduate School of Medical Sciences Kyushu University, Fukuoka, Japan
| | - Yasutomo Momii
- Department of Neurosurgery, Oita University, Yufu, Oita, Japan
| | - Yoshihiro Muragaki
- Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Tatsuya Abe
- Department of Neurosurgery, Faculty of Medicine, Saga University, Saga, Japan
| | - Jiro Akimoto
- Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan
| | - Toshihiko Wakabayashi
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Ryuta Saito
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan
| | - Seishi Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroshi Haeno
- Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Kashiwa-shi, Chiba, Japan.,Corresponding Authors: Kosuke Aoki, Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya 4668550, Japan. Phone: 815-2744-2353; E-mail: ; Hiroshi Haeno, ; and Atsushi Natsume,
| | - Atsushi Natsume
- Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya, Aichi, Japan.,Institute of Nano-Life-Systems, Institutes of Innovation for Future Society, Nagoya University, Nagoya, Aichi, Japan.,Corresponding Authors: Kosuke Aoki, Department of Neurosurgery, Graduate School of Medicine, Nagoya University, Nagoya 4668550, Japan. Phone: 815-2744-2353; E-mail: ; Hiroshi Haeno, ; and Atsushi Natsume,
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Endo Y, Kawashiri SY, Nishino A, Michitsuji T, Tomokawa T, Nishihata S, Okamoto M, Tsuji Y, Tsuji S, Shimizu T, Sumiyoshi R, Igawa T, Koga T, Iwamoto N, Ichinose K, Tamai M, Nakamura H, Origuchi T, Ueki Y, Yoshitama T, Eiraku N, Matsuoka N, Okada A, Fujikawa K, Otsubo H, Takaoka H, Hamada H, Tsuru T, Nawata M, Arinobu Y, Hidaka T, Tada Y, Kawakami A. Ultrasound efficacy of targeted-synthetic disease-modifying anti-rheumatic drug treatment in rheumatoid arthritis: a multicenter prospective cohort study in Japan. Scand J Rheumatol 2021; 51:259-267. [PMID: 34474646 DOI: 10.1080/03009742.2021.1927389] [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: 10/20/2022]
Abstract
OBJECTIVE This study investigated the effectiveness of treatment with Janus kinase (JAK) inhibitors in rheumatoid arthritis (RA) assessed by ultrasonography (US) activity, and the influence of patient characteristics and previous treatments. METHOD This prospective study assessed 60 treatment initiations among 53 Japanese patients diagnosed with RA who underwent treatment with JAK inhibitors during June 2013 to February 2020. Of the 53 patients, seven patients were enrolled in duplicate because they were treated with two different JAK inhibitors at different periods. For each case, the improvement rate on the power Doppler (PD) score was assessed at 6 month follow-up. Median improvement rate of PD score was used to classify cases as either US responders or non-responders, and patient characteristics were compared between the two groups. RESULTS All indicators of clinical disease activity and US activity showed a significant improvement at 3 months compared with baseline. Although the JAK inhibitor-cycler group and the interleukin-6 (IL-6) inhibitor inadequate response (IR) group tended to show a later improvement for US activity, all indicators of clinical disease activity and US activity showed a significant improvement at 6 months compared with baseline for both groups. Multivariate analysis showed that concomitant methotrexate use and an IR to the previous biologic or targeted-synthetic disease-modifying anti-rheumatic drug (b/tsDMARD) treatment were independently and significantly associated with US responders. CONCLUSION Use of a JAK inhibitor in combination with methotrexate and an absence of IR to any previous b/tsDMARDs demonstrated superior effectiveness for patients with RA.
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Affiliation(s)
- Y Endo
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - S-Y Kawashiri
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - A Nishino
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Michitsuji
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Tomokawa
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - S Nishihata
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - M Okamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Y Tsuji
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - S Tsuji
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - T Shimizu
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - R Sumiyoshi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - T Igawa
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - T Koga
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - N Iwamoto
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - K Ichinose
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - M Tamai
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - H Nakamura
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - T Origuchi
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan
| | - Y Ueki
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Yoshitama
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - N Eiraku
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - N Matsuoka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - A Okada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - K Fujikawa
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - H Otsubo
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - H Takaoka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - H Hamada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Tsuru
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - M Nawata
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - Y Arinobu
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - T Hidaka
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - Y Tada
- Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
| | - A Kawakami
- Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Medical Sciences, Nagasaki, Japan.,Kyushu Multicenter Rheumatoid Arthritis Ultrasound Prospective Observational Cohort Study Group, Kyushu, Japan
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45
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Sugita Y, Hashimoto G, Fukuda K, Takahashi K, Shioga T, Furuta T, Arakawa F, Ohshima K, Nakamura H, Miyata H, Watanabe M, Kakita A. Primary Nondural Central Nervous System Marginal ZoneB-Cell Lymphoma of the Mucosa-Associated Lymphoid Tissue Type Mimicking CNS Inflammatory Diseases. J Neuropathol Exp Neurol 2021; 80:789-799. [PMID: 34383910 DOI: 10.1093/jnen/nlab058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Marginal zone B-cell lymphomas (MZBCLs) are non-Hodgkin lymphomas arising from postgerminal center marginal zone B cells. MZBCLs are subclassified into extranodal, nodal, and splenic MZBCLs. Primary nondural central nervous system (CNS) MZBCLs of the mucosa-associated lymphoid tissue (MALT) type are among the extranodal examples. Their clinicopathological features are not well characterized. Therefore, the clinicopathological features of 8 primary nondural CNS MZBCLs of the MALT type were assessed to establish their pathological diagnostic criteria. Histologically, all cases of primary nondural CNS MZBCLs of the MALT type showed perivascular expansive monotonous proliferation of small atypical B lymphoid cells with plasma cell differentiation, low Ki-67 labeling index, and minimal invasion from the perivascular space. In addition, no vascular changes such as glomeruloid changes, obliterative fibrointimal proliferation, and intramural lymphocytic infiltration were seen. These key histological characteristics should be considered when diagnosing cases that are suspected to be primary nondural CNS MZBCLs of the MALT type. Additionally, regarding PCR for the detection of immunoglobulin heavy variable gene and T-cell receptor γ gene rearrangements, the former is detected, but the latter is not detected in all cases. Therefore, PCR detection including sequence analysis should be added when diagnosing difficult cases based on the key histological characteristics.
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Affiliation(s)
- Yasuo Sugita
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Go Hashimoto
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Kenji Fukuda
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Kenji Takahashi
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Taro Shioga
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Takuya Furuta
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Fumiko Arakawa
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Koichi Ohshima
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Hideo Nakamura
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Hajime Miyata
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Masashi Watanabe
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
| | - Akiyoshi Kakita
- From the Department of Neuropathology, St. Mary's Hospital, Kurume, Japan (YS); Department of Cerebrovascular Medicine, St. Mary's Hospital, Kurume, Japan (GH, KF); Department of Neurosurgery, St. Mary's Hospital, Kurume, Japan (KT); Department of Pathology, St. Mary's Hospital, Kurume, Japan (TS); Department of Pathology, Kurume University School of Medicine, Kurume, Japan (TF, FA, KO); Department of Neurosurgery, Kurume University School of Medicine, Kurume, Japan (HN); Department of Neuropathology, Research Institute for Brain and Blood Vessels, Akita Cerebrospinal and Cardiovascular Center, Akita, Japan (HM); Department of Neurology, Ehime Prefectural Central Hospital, Ehime, Japan (MW); and Department of Pathology, Brain Research Institute, Niigata University, Niigata, Japan (AK)
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Yamada Y, Inui K, Okano T, Mandai K, Mamoto K, Koike T, Tateishi C, Tsuruta D, Nakamura H. POS1059 ULTRASOUND SYNOVITIS, UNLIKE ENTHESITIS OR CLINICAL JOINT ASSESSMENT, IS ASSOCIATED WITH JOINT DAMAGE PROGRESSION IN PATIENTS WITH PSORIATIC ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:We previously reported that ultrasound assessment of enthesitis (US enthesitis) is not consistent with tenderness of the enthesis (clinical enthesitis) in patients with psoriatic arthritis (PsA). Although US enthesitis reflects inflammatory condition and clinical enthesitis is associated with disease activity and physical function, each of them was not associated with joint destruction by cross-sectional analysis1. It is reported that the utility of US for predicting joint destruction remains unclear among patients with PsA2.Objectives:This study is aimed to longitudinally investigate the relationships between enthesitis or synovitis and joint damage progression in patients with PsA.Methods:Forty-seven patients with PsA (average age of 56.5 years) underwent US and clinical examination of wrist and finger joints and 14 entheses (the bilateral humeral medial epicondyles and insertions of the triceps, distal quadriceps, proximal/distal patella, Achilles tendons, and plantar fascia). Tender or swollen joint count (TJC/SJC), Gray Scale (GS) and Power Doppler (PD) score of the joints, and US/clinical enthesitis counts were calculated. The relationships between the yearly progression in modified total sharp score (ΔmTSS) at two-time points (baseline and average follow-up of 20.4 months) and US or clinical findings were investigated.Results:ΔmTSS was significantly correlated with age (r=0.44, p=0.01), joint GS score (r=0.44, p=0.01), and joint PD score (r=0.38, p=0.03). TJC, SJC, inflammatory marker, and disease activity showed no associations with ΔmTSS. US/clinical enthesitis counts also showed no associations with ΔmTSS (Table 1). The joint PD score, adjusted by age, was significant factor for ΔmTSS by multiple regression analysis (b=0.50, p<0.001).Conclusion:The joint PD score or US synovitis, unlike clinical joint assessment, was significant predictive factor for joint damage progression. It is important to assess joints by US as well as clinical examination.References:1) Yutaro Yamada et al. Ultrasound assessment, unlike clinical assessment, reflects enthesitis in patients with psoriatic arthritis. Clin Exp Rheumatol. 2020 Apr 17. Online ahead of print.2) van der Heijde et al. Assessing structural damage progression in psoriatic arthritis and its role as an outcome in research. Arthritis Res Ther. 2020, 22(1): 18.Table 1.Univariate analysis of predictive factors for joint damage progression in PsA patients.mTSS at baselineΔmTSSR valuep valueR valuep valueage0.55<0.0010.440.01PASE0.040.810.120.52PASI-0.250.15-0.010.96DAS28CRP-0.050.750.070.71DAPSA-0.010.94-0.010.97HAQ0.170.27-0.070.73CRP-0.130.380.230.20MMP-30.040.800.290.12biologics use0.190.19-0.110.54Clinical enthesitis counts-0.010.97-0.190.30TJC-0.050.76-0.100.58SJC0.210.180.130.48US enthesitis counts0.120.44-0.130.48joint GS score0.080.600.440.01joint PD score0.080.600.380.03PsA: psoriatic arthritis, mTSS: modified Total Sharp Score, PASE: Psoriatic Arthritis Screening and Evaluation, PASI: Psoriasis Area Severity Index, DAPSA: Disease Activity in Psoriatic Arthritis, DAS: Disease Activity Score, CRP: C-reactive protein, HAQ: Health Assessment Questionnaire, MMP-3: matrix metalloproteinase 3, TJC: tender joint counts, SJC: swollen joint counts, GS: Gray Scale, PD: Power DopplerDisclosure of Interests:Yutaro Yamada: None declared, Kentaro Inui Speakers bureau: Abbvie, Eisai, Eli Lilly, Grant/research support from: Abbvie, Eisai, Chigai, Eli Lilly, Daiichi Sankyo, Mitusbishi Tanabe, Pfizer, UCB, Tadashi Okano Speakers bureau: Abbvie, Koji Mandai: None declared, Kenji Mamoto: None declared, Tatsuya Koike Grant/research support from: Abbvie, Chugai, Chiharu Tateishi: None declared, Daisuke Tsuruta Speakers bureau: Abbvie, Astellas, Bristol-Myers Squibb, Celgene, Eli Lilly, Janssen, Novartis, Sanofi, Grant/research support from: Abbvie, Eli Lilly, Bristol-Myers Squibb, UCB, Hiroaki Nakamura Grant/research support from: Astellas, Asahi Kasei
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Yamada Y, Tada M, Mandai K, Hidaka N, Nakamura H. AB0813 DEVELOPING SARCOPENIA IS A RISK FACTOR FOR FRACTURES IN PATIENTS WITH RHEUMATOID ARTHRITIS: 4-YEAR DATA FROM THE CHIKARA STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Patients with rheumatoid arthritis (RA) tend to have sarcopenia due to decreased muscle mass and function. We previously reported that 13.2% of RA patients without sarcopenia at baseline developed sarcopenia over a year using data from the prospective, observational CHIKARA study1.Objectives:The aim was to investigate sarcopenia status and the characteristics of RA patients longitudinally.Methods:Body composition, laboratory data, disease activity, physical function, treatment, and history of falls and fractures were investigated in 100 RA patients who participated in the CHIKARA study at baseline and at 4 years. The patients were divided into 4 groups depending on their sarcopenia status: no sarcopenia development (N group), sarcopenia development (S group), cured (C group), and persisted (P group).Results:Of the 77 RA patients who completed the survey, 48 were in the N group; their body mass index, skeletal muscle mass index, fat percentage, estimated bone mass, and body metabolization rate at baseline were significantly elevated. On the other hand, 6 patients were in the S group; 83.3% of them experienced fractures during the 4 years, significantly more than in the other groups. Ten patients were in the P group, and their baseline MMP-3 was significantly higher than in the other groups. Thirteen patients were in the C group. There were no differences among the 4 groups in disease activity and physical function (Table 1).Table 1.Characteristics of 77 RA patients by sarcopenia status at baseline and at 4-year follow-up.no development(n=48)development(n=6)cured(n=10)persisted(n=13)p valueBaseline age, years64.5 (57.8, 72)70.0 (65.5, 72.3)61.0 (54.5, 68.3)72 (68, 81)0.062 disease duration, years4.6 (1.1, 9.9)11.7 (2.8, 18.9)8.1 (4.2, 14.3)4.0 (2.2, 7.7)0.427 biologics use, %37.516.730.023.10.617 GC use, %27.116.710.023.10.678 MMP-3, ng/ml66.8 (51.8, 103)52.5 (40.0, 56.7)82.8 (57.8, 186)157.5 (90.8, 250)0.001 DAS28ESR3.43 ± 0.873.48 ± 1.323.36 ± 1.083.80 ± 1.270.661 mHAQ0.31 (0, 0.50)0.19 (0.03, 0.44)0.38 (0, 0.84)0.50 (0.25, 0.88)0.383 BMI, kg/m223.4 ± 3.621.6 ± 2.419.2 ± 1.619.5 ± 2.6<0.001 SMI, kg/m26.8 ± 0.86.2 ± 0.65.8 ± 0.55.7 ± 0.6<0.001 fat percentage, %30.4 ± 8.429.1 ± 9.123.9 ± 4.025.1 ± 8.30.046 estimated bone mass, kg2.2 (2.0, 2.4)1.9 (1.8, 2.1)2.0 (1.7, 2.1)1.7 (1.7, 1.9)0.012 BMR, kcal1100 (1031, 1197)1029 (918, 1070)1012 (917, 1057)934 (894, 1006)0.005Change during 4 years ΔDAS28ESR-0.34 ± 0.97-0.52 ± 0.98-0.60 ± 1.46-0.56 ± 1.140.834 ΔmHAQ0 (-0.25, 0.16)0.19 (0, 0.56)-0.06 (-0.44, 0.94)0 (-0.38, 0.38)0.357 ΔSMI, kg/m20.0 ± 0.3-0.6 ± 0.30.3 ± 0.4-0.0 ± 0.3<0.001 fall, %43.883.330.023.10.079 fracture, %14.683.320.023.10.002Data are shown as mean ± standard deviation (SD) or median (25th, 75th percentile).GC: glucocorticoids, BMI: body mass index, SMI: skeletal muscle mass index, BMR: body metabolization rate.Conclusion:Overall, 7.8% of RA patients developed sarcopenia during the 4-year follow-up period, and they developed fractures more frequently. Evaluation of sarcopenia is important for risk assessment of fractures.References:[1]Y Yamada, M Tada, K Mandai et al. Glucocorticoid use is an independent risk factor for developing sarcopenia in patients with rheumatoid arthritis: from the CHIKARA study. Clin Rheumatol 2020 Jun;39(6):1757-1764.Disclosure of Interests:Yutaro Yamada: None declared, Masahiro Tada: None declared, Koji Mandai: None declared, Noriaki Hidaka: None declared, Hiroaki Nakamura Grant/research support from: Astellas and Asahi Kasei
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Yoshimura H, Koike T, Mamoto K, Sugioka Y, Okano T, Tada M, Inui K, Nakamura H. POS0532 AveRAGE PREDNISOLONE DOSE OF ONLY 1 MG PER DAY WAS RISK FACTOR FOR CLINICAL FRACTURES IN PATIENTS WITH RHEUMATOID ARTHRITIS - NINE-YEAR FINDINGS OF THE TOMORROW STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Previous cohort studies showed that the use of prednisolone (PSL) was a risk factor for clinical fractures in patients with rheumatoid arthritis (RA). However, there are few reports on relationship between PSL dose and clinical fractures.Objectives:The present study aimed to determine the effect of PSL dose on the incidence of clinical fractures in the RA patients treated with PSL.Methods:We evaluated anthropoetric parameters, bone mineral density (BMD), disease activity score 28-erythrocyte sedimentation rate (DAS28-ESR), RA medication (methotrexate (MTX) dose, use of biologic disease modified anti-rheumatic-drugs (bDMARDs), and PSL dose) and the incidence of clinical fractures during nine years in RA patients who participant the TOMORROW study (UMIN000003876), which is a 10-years prospective cohort study. Data on clinical fracture was self-reported on the questionnaires. In this analysis, the data of RA patients treated with PSL at least once during nine-year period were evaluated. We analyzed the average dose of PSL until the incidence of the clinical fractures. The risk factor for clinical fractures were analyzed by using Cox proportional hazard model with adjustment for age, sex, body mass index (BMI), and smoking history.Results:We analyzed the data of 67 RA patients treated with PSL. Among them, median age was 61.8 year, 56 patients (83.6%) were female, 47 patients (70.1%) were never smoker and median disease duration was 12.1 year. The number of patients treated with PSL at baseline was 48 (69.1%). During 9 years, 23 clinical fractures were observed in 67 patients, and the incidence of clinical fracture was 0.046/person-year. In 19 patients, who were not treated with PSL at baseline but treated with PSL at least once during 9 years, 5 clinical fractures were observed. In 67 RA patients, Cox proportional hazard analysis revealed that baseline disease activities, BMD at thoracic vertebrae and medication were not significant risk factors for clinical fractures. However, average PSL dose of more than only 1 mg/day was a significant risk factor for the incidence of clinical fracture (hazard ratio (HR): 2.80; p=0.03) (Table 1).Table 1.Adjusted hazard ratio for clinical fractures in patients with rheumatoid arthritis treated with PSL.* Adjusted Hazard ratio95% Confidence intervalP valueCRP (mg/dL)1.290.88-1.910.19RF (IU/mL)0.990.99-1.000.07ACPA (U/mL)0.990.98-1.000.18DAS28-ESR0.990.71-1.390.97BMD at thoracic vertebrae (mg/cm2)0.020.00-1.000.05bDMARDs use0.550.23-1.320.18Bisphosphonate use2.330.95-5.710.07average dose of MTX (mg/week)1.020.92-1.120.74average score of DAS28-ESR1.150.76-1.750.52average dose of PSL more than 1mg/day2.81.09-7.240.03*Hazard ratio was adjusted for age, sex, body mass index (BMI), and smoking history. RF, Rheumatoid factor; ACPA, Anti-cyclic citrullinated peptide antibody; DAS28-ESR, disease activity score 28-erythrocyte sedimentation rate; BMD, Bone mineral density; bDMARDs, biologic disease modified anti-rheumatic-drugs; MTX, methotrexate; PSL, prednisolone.Conclusion:In RA patients treated with PSL, average PSL dose of only 1mg/day significantly increased the risk for the incidence of clinical fractures. Even for established RA patients, continuous use or initiation of low PSL dose was apparently significant risk factor for clinical fractures.Disclosure of Interests:Hitoshi Yoshimura: None declared, Tatsuya Koike Grant/research support from: Takeda Pharmaceutical, Mitsubishi Tanabe Pharma Corporation, Chugai Pharmaceutical, Eisai, Abbott Japan, Teijin Pharma, Banyu Pharmaceutical and Ono Pharmaceutical, Kenji Mamoto: None declared, Yuko Sugioka: None declared, Tadashi Okano: None declared, Masahiro Tada: None declared, Kentaro Inui Grant/research support from: Janssen Pharmaceutical K.K. and Astellas Pharma Inc, Hiroaki Nakamura: None declared
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Mandai K, Tada M, Yamada Y, Koike T, Okano T, Hidaka N, Nakamura H. POS0517 A LONGITUDINAL STUDY OF SARCOPENIA, LOCOMOTIVE SYNDROME, AND FRAILTY IN PATIENTS WITH RHEUMATOID ARTHRITIS: FROM THE CHIKARA STUDY. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Rheumatoid arthritis (RA) patients have a high frequency of sarcopenia, and they commonly have reduced physical function. We previously reported that the prevalence of sarcopenia was 28%, that of frailty was 18.9%, and that of pre-frailty was 38.9% in RA patients1,2, and 13.2% of RA patients developed sarcopenia within a year 3.Objectives:To investigate the risk factors for new onset of sarcopenia, locomotive syndrome, and frailty in patients with RA and the course of each disease.Methods:Two-year follow-up data from the rural group of the prospective, observational CHIKARA study were used. Sarcopenia was diagnosed using the criteria of the Asian Working Group for Sarcopenia 2014, locomotive syndrome was diagnosed using locomotive 5, and frailty was diagnosed using the basic checklist. New onset of the disease over the 2-year follow-up period was studied, excluding cases that had the disease at baseline. Improvement was defined as cases with disease at baseline that no longer met the diagnostic criteria after 2 years. Differences in the characteristics of each disease were tested using the Chi-squared test and the paired t-test.Results:The 81 patients with RA (82.7% female) had mean age 66.9±11.5 years, mean DAS28-ESR 2.9±1.2, methotrexate use in 81.5% (with a dose of 9.9±2.7 mg/week), and glucocorticoid (GC) use in 22.2% (with a dose of 3.1±1.7 mg/week). The baseline prevalence was 44.4% for sarcopenia, 35.8% for locomotive syndrome, and 25.9% for frailty, and the new onset rate was 4.4% for sarcopenia, 15.4% for locomotive syndrome, and 13.3% for frailty. Of the patients with each disease at baseline, 36.1% had sarcopenia, 20.7% had locomotive syndrome, and 33.3% had frailty, and of those with each disease at 2 years, 36.1% had sarcopenia, 20.7% had locomotive syndrome, and 33.3% had frailty. The new onset sarcopenia and locomotive syndrome groups had significantly higher rates of GC use (p=0.036, p=0.007, paired t-test) and significantly higher doses (p=0.01, p=0.001, paired t-test) than the groups without new onset sarcopenia and locomotive syndrome. High baseline disease activity was an independent predictor of new onset of locomotive syndrome on multivariate logistic regression analysis (OR=3.21, p=0.015).Conclusion:The new onset rates at 2 years were 4.4% for sarcopenia, 15.4% for locomotive syndrome, and 13.3% for frailty. In the new onset sarcopenia and locomotive syndrome groups, both GC use and dosage were significantly higher.References:[1]Tada M, et al. Matrix metalloprotease 3 is associated with sarcopenia in rheumatoid arthritis - results from the CHIKARA study. Int J Rheum Dis. 2018 Nov;21(11):1962-1969.[2]Tada M, et al. Correlation between frailty and disease activity in patients with rheumatoid arthritis: Data from the CHIKARA study. Geriatr Gerontol Int. 2019 Dec;19(12):1220-1225.[3]Yamada Y, et al. Glucocorticoid use is an independent risk factor for developing sarcopenia in patients with rheumatoid arthritis: from the CHIKARA study. Clin Rheumatol. 2020 Jun;39(6):1757-1764.Disclosure of Interests:None declared
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Okano T, Koike T, Inui K, Mamoto K, Yamada Y, Mandai K, Anno S, Nakamura H. AB0115 COMPARISON OF ULTRASOUND FINDINGS BETWEEN TNF INHIBITORS AND NON-TNF INHIBITORS AT FIRST BIOLOGICS IN PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:In rheumatoid arthritis (RA), biologics treatment is one of the effective treatment options. Usually, there is no difference in therapeutic effect regardless of which biologics is used, but the effect for joint synovitis is unknown. Recently, ultrasound (US) has played a role of sensitive imaging modality in the diagnosis and follow-up of patients with RA.Objectives:The aim of this study was to compare the improvement of US findings between TNF inhibitors and non-TNF inhibitors at first biologics in patients with RA.Methods:Fifty-four RA patients who started the first biologics from September 2016 to December 2018 were included in this longitudinal study (SPEEDY study, UMIN000028260). All the patients were performed clinical examination, blood test and US examination at baseline, 4, 12, 24, 36 and 52 weeks. A US examination was performed at the bilateral first to fifth metacarpophalangeal (MCP) joints, first interphalangeal (IP) and second to fifth proximal interphalangeal (PIP) joints, wrist joints (three part of radial, medial and ulnar) and first to fifth metatarsophalangeal (MTP) joints, by using HI VISION Ascendus (Hitachi Medical Corporation, Japan) with a multifrequency linear transducer (18-6 MHz). The gray scale (GS) and power Doppler (PD) findings were assessed by the semi-quantitative method (0-3). GS score and PD score (both 0-108 points) were defined as the sum of each score. The change of disease activity and US findings were compared between TNF group and non-TNF group.Results:Among 54 cases, 32 patients were used TNF inhibitor and 22 were non-TNF inhibitor. Age and duration of RA were significantly higher in the non-TNF group, and MTX dose was significantly lower in the non-TNF group. The baseline inflammatory markers tended to be higher in the non-TNF group and the disease activity was also higher in the non-TNF group. However, the US findings showed no significant difference in both GS and PD between two groups at baseline. US improvement ratio was no difference between TNF group and non-TNF group at 4, 12, 24, 36 and 52 weeks in both GS and PD score. Regardless of the type of biologics, patients with long-term disease duration tended to have poor improvement in US synovial fingings.Table 1.Baseline patient and disease characteristicsTNF (n=32)non-TNF (n=22)P valueFemale patients, n (%)21 (65.6)16 (72.7)0.767Age (years)63.5±15.471.0±9.00.030Disease duration (years)6.5±8.213.0±11.70.032CRP (mg/dl)1.8±2.53.0±3.20.170DAS28-ESR5.0±1.45.8±1.20.022GS score26.1±18.831.8±21.10.313PD score17.6±11.423.1±14.60.150Figure 1.GS and PD improvement ratio at 4, 12, 24, 36 and 52 weeksConclusion:There was no difference in the US findings improvement between patients with TNF inhibitor and non-TNF inhibitor at first biologics in patients with RA.References:[1]Grassi W, Okano T, Di Geso L, Filippucci E. Imaging in rheumatoid arthritis: options, uses and optimization. Expert Rev Clin Immunol. 2015;11:1131-46.[2]Nishino A, Kawashiri SY, Koga T, et al. Ultrasonographic Efficacy of Biologic andTargeted Synthetic Disease-ModifyingAntirheumatic Drug Therapy in RheumatoidArthritis From a Multicenter RheumatoidArthritis Ultrasound Prospective Cohort in Japan. Arthritis Care Res (Hoboken). 2018;70:1719-26.Acknowledgements:We wish to thank Atsuko Kamiyama, Tomoko Nakatsuka for clinical assistant, Setsuko Takeda, Emi Yamashita, Yuko Yoshida, Rika Morinaka, Hatsue Ueda and Tomomi Iwahashi for their special efforts as a sonographer and collecting data.Disclosure of Interests:None declared
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