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Mochizuki F, Tanabe N, Shimada T, Iijima H, Sakamoto R, Shiraishi Y, Maetani T, Shimizu K, Suzuki M, Chubachi S, Ishikawa H, Naito T, Kanasaki M, Masuda I, Oguma T, Sato S, Hizawa N, Hirai T. Centrilobular emphysema and airway dysanapsis: factors associated with low respiratory function in younger smokers. ERJ Open Res 2024; 10:00695-2023. [PMID: 38444662 PMCID: PMC10910308 DOI: 10.1183/23120541.00695-2023] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/18/2024] [Indexed: 03/07/2024] Open
Abstract
Background Low respiratory function in young adulthood is one of the important factors in the trajectory leading to the future development of COPD, but its morphological characteristics are not well characterised. Methods We retrospectively enrolled 172 subjects aged 40-49 years with ≥10 pack-years smoking history who underwent lung cancer screening by computed tomography (CT) and spirometry at two Japanese hospitals. Emphysema was visually assessed according to the Fleischner Society guidelines and classified into two types: centrilobular emphysema (CLE) and paraseptal emphysema (PSE). Airway dysanapsis was assessed with the airway/lung ratio (ALR), which was calculated by the geometric mean of the lumen diameters of the 14 branching segments divided by the cube root of total lung volume on a CT scan. Results Among the subjects, CLE and PSE were observed in 20.9% and 30.8%, respectively. The mean ALR was 0.04 and did not differ between those with and without each type of emphysema. Multivariable regression analysis models adjusted for age, sex, body mass index and smoking status indicated that CLE and a low ALR were independently associated with lower forced expiratory volume in 1 s (FEV1)/forced vital capacity (estimate -1.64 (95% CI -2.68- -0.60) and 6.73 (95% CI 4.24-9.24), respectively) and FEV1 % pred (estimate -2.81 (95% CI -5.10- -0.52) and 10.9 (95% CI 5.36-16.4), respectively). Conclusions CLE and airway dysanapsis on CT were independently associated with low respiratory function in younger smokers.
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Affiliation(s)
- Fumi Mochizuki
- Department of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Naoya Tanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takafumi Shimada
- Department of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Hiroaki Iijima
- Department of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Ryo Sakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yusuke Shiraishi
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoki Maetani
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kaoruko Shimizu
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Masaru Suzuki
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Shotaro Chubachi
- Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroichi Ishikawa
- Department of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Takashi Naito
- Department of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | | | - Izuru Masuda
- Clinical Research Institute, National Hospital Organization, Kyoto Medical Center, Kyoto, Japan
| | - Tsuyoshi Oguma
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Respiratory Medicine, Kyoto City Hospital, Kyoto, Japan
| | - Susumu Sato
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Nobuyuki Hizawa
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Tochio T, Kawano K, Iyori K, Makida R, Kadota Y, Fujii T, Ishikawa H, Yasutake T, Watanabe A, Funasaka K, Hirooka Y, Nishifuji K. Topical erythritol combined with L-ascorbyl-2-phosphate inhibits staphylococcal growth and alleviates staphylococcal overgrowth in skin lesions of canine superficial pyoderma. Pol J Vet Sci 2023; 26:647-655. [PMID: 38088308 DOI: 10.24425/pjvs.2023.148284] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Erythritol (ERT) and L-ascorbyl-2-phosphate (APS) are bacteriostatic, but their effects on staphylococcal skin infections remain unknown. We aimed to determine whether ERT combined with APS inhibits the growth of staphylococci that are commonly isolated from pyoderma skin lesions in dogs. We investigated the individual and combined effects of ERT and APS on the growth of Staphylococcus pseudintermedius, S. schleiferi, and S. aureus using turbidity assays in vitro. Skin lesions from 10 dogs with superficial pyoderma were topically treated with 5% ERT and 0.1% APS for 28 days, and swabbed skin samples were then analyzed using 16S rRNA amplicon sequencing and quantitative real-time PCR (qPCR). Results showed that ERT inhibited S. pseudintermedius growth regardless of harboring the mecA gene, and APS increased the inhibitory effects of ERT against S. pseudintermedius, S. schleiferi, and S. aureus in vitro. Moreover, combined ERT and APS decreased the prevalence of staphylococci on canine skin lesions at the genus level. The combination slightly increased the α-diversity but did not affect the β-diversity of the microbiota. The qPCR results revealed that the combination significantly decreased S. pseudintermedius and S. schleiferi in skin lesions. Topical administration of EPS combined with APS can prevent staphylococcal colonization on the surface of mammalian skin. The results of this study may provide an alternative to systemic antibiotics for treating superficial pyoderma on mammalian skin surfaces.
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Affiliation(s)
- T Tochio
- B Food Science Co., Ltd., 24-12, Kitahama-machi, Chita, Aichi 478-0046, Japan
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake, Aichi 470-1192, Japan
| | - K Kawano
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake, Aichi 470-1192, Japan
- Tokyo Animal Allergy Center, 4-23-15, Kurihara, Adachi-ku, Tokyo 123-0842, Japan
| | - K Iyori
- Vet Derm Tokyo, Dermatological and Laboratory Service for Animals, 910 Shoubusawa, Fujisawa, Kanagawa 252-0823, Japan
| | - R Makida
- B Food Science Co., Ltd., 24-12, Kitahama-machi, Chita, Aichi 478-0046, Japan
| | - Y Kadota
- B Food Science Co., Ltd., 24-12, Kitahama-machi, Chita, Aichi 478-0046, Japan
| | - T Fujii
- B Food Science Co., Ltd., 24-12, Kitahama-machi, Chita, Aichi 478-0046, Japan
| | - H Ishikawa
- Healthcare Systems Co., Ltd., Nagoya Aichi, 466-0058, Japan
| | - T Yasutake
- Healthcare Systems Co., Ltd., Nagoya Aichi, 466-0058, Japan
| | - A Watanabe
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake, Aichi 470-1192, Japan
| | - K Funasaka
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake, Aichi 470-1192, Japan
| | - Y Hirooka
- Department of Gastroenterology and Hepatology, Fujita Health University, Toyoake, Aichi 470-1192, Japan
| | - K Nishifuji
- Division of Animal Life Science, Institute of Agriculture, Graduate School, Tokyo University of Agriculture and Technology, 3-5-8 Saiwai-cho, Fuchu, Tokyo 183-8509, Japan
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Harada H, Suefuji H, Mori K, Ishikawa H, Nakamura M, Tokumaru S, Murakami M, Ogino T, Iwata H, Tatebe H, Kubo N, Waki T, Yoshida D, Nakamura M, Aoyama H, Araya M, Nakajima M, Nakayama H, Satouchi M, Shioyama Y. Proton and Carbon Ion Radiotherapy for Operable Early-Stage Lung Cancer: 3-Year Results of a Prospective Nationwide Registry. Int J Radiat Oncol Biol Phys 2023; 117:e23. [PMID: 37784924 DOI: 10.1016/j.ijrobp.2023.06.698] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) The purpose of this analysis was to report subset analysis as to progression-free survival (PFS) and overall survival (OS) of particle-beam radiation therapy for operable early-stage lung cancer. MATERIALS/METHODS Patients of early-stage lung cancer (T1-T2aN0) who were eligible for radical surgery but did not wish to undergo surgery were treated by proton-ion (PT) or carbon-ion (CT) radiation therapy and enrolled in Japanese prospective registry. In this analysis, PFS and OS by clinical stage, tumor location, pathological confirmation and particle-ion type were evaluated. RESULTS A total of 274 patients were enrolled and included in efficacy and safety analyses. Most tumors were adenocarcinoma (44%), and 105 (38%) were not histologically confirmed and diagnosed clinically. 250 (91%) of 274 patients had tumors that were peripherally situated. 138 (50%) and 136 (50%) patients were treated by PT and CT, respectively. The median follow-up time for all censored patients was 42.8 months (IQR 36.7 - 49.0). No grade 3 or severe treatment-related toxicity was observed. 3-year PFS was 81% (95% CI;76-86) and OS was 93% (95% CI;89-96), respectively. As to particle-ion type, 3-year PFS were 79.0% and 81.9% in PT and CT (p = 0.19), and 3-year OS were 93.9% and 91.1% in PT and CT (P = 0.72), respectively. For PFS, pathological confirmation, clinical stage was significant factors but there were no significant differences by tumor location or particle-ion type; for OS, clinical stage was significant factor but there was no significant difference on pathological confirmation, tumor location or particle-ion type (Table1). Table 1. 3-year PFS and OS CONCLUSION: Particle therapy for operable early-stage lung cancer resulted in excellent 3-year OS and PFS on each subset.
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Affiliation(s)
- H Harada
- Radiation and Proton Therapy Center, Shizuoka Cancer Center, Shizuoka, Japan
| | - H Suefuji
- Ion Beam Therapy Center, SAGA HIMAT Foundation, Tosu, Japan
| | - K Mori
- Shizuoka Cancer Center, Nagaizumi, Japan
| | - H Ishikawa
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - M Nakamura
- Department of Radiation Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - S Tokumaru
- Department of Radiology, Hyogo Ion Beam Medical Center, Tatsuno, Hyogo, Japan
| | - M Murakami
- Department of Radiation Oncology, Southern TOHOKU Proton Therapy Center, Koriyama, Japan
| | - T Ogino
- Medipolis Proton Therapy and Research Center, Ibusuki, Japan
| | - H Iwata
- Department of Radiation Oncology, Nagoya Proton Therapy Center, Nagoya City University West Medical Center, Nagoya, Japan
| | - H Tatebe
- Fukui Prefectural Hospital Proton Therapy Center, Fukui, Japan
| | - N Kubo
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - T Waki
- Tsuyama Chuo Hospital, Tsuyama, Japan
| | - D Yoshida
- Kanagawa Cancer Center, Yokohama, Japan
| | - M Nakamura
- University of Tsukuba, Tsukuba City 305-8575, Japan
| | - H Aoyama
- Department of Radiation oncology, Faculty and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - M Araya
- Proton Therapy Center, Aizawa Hospital, Matsumoto, Japan
| | - M Nakajima
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - H Nakayama
- Kanagawa Prefectural Hospital Organization, Yokohama, Japan
| | | | - Y Shioyama
- Ion Beam Therapy Center, SAGA HIMAT Foundation, Tosu, Japan
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Tamura T, Numata T, Yanai H, Nakamura R, Shiozawa T, Watanabe H, Okauchi S, Kikuchi N, Miyazaki K, Hayashi S, Yamashita T, Kurishima K, Inagaki M, Satoh H, Ishikawa H, Kaburagi T, Endo T, Sakamoto T, Hizawa N. Atezolizumab for EGFR-mutated Non-small Cell Lung Cancer Patients: An Observation Study in Ibaraki Group (ATTENTION-IBARAKI). Anticancer Res 2023; 43:4583-4591. [PMID: 37772562 DOI: 10.21873/anticanres.16652] [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: 07/23/2023] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND/AIM Atezolizumab, an anti-programed death-ligand 1 monoclonal antibody, targets programed death-ligand 1 expressed on cancer cells and antigen-presenting cells and is now commonly used in combination with chemotherapy. We conducted a study to clarify the efficacy of atezolizumab in epidermal growth factor receptor (EGFR)-mutated patients who are considered less responsive to immune checkpoint inhibitors. PATIENTS AND METHODS A retrospective review of patients with advanced non-small cell lung cancer (NSCLC) who received atezolizumab-containing therapy at 11 hospitals from April 2018 to March 2023 was performed. RESULTS Median progression-free survival and overall survival in 33 EGFR-mutated patients treated with atezolizumab monotherapy were 2.0 and 9.0 months, respectively, and those in 19 patients who received combined atezolizumab plus chemotherapy were 12.0 and 17.0 months, respectively. When comparing EGFR-mutated and EGFR-negative patients after propensity score matching, there were no significant differences in progression-free survival and overall survival between the two groups, whether atezolizumab monotherapy or combined atezolizumab plus chemotherapy. Among EGFR-mutated patients, being male was a significant favorable factor in both atezolizumab treatment groups. None of the EGFR-mutated patients had grade 5 immune-related adverse events. CONCLUSION Efficacy of atezolizumab in EGFR-mutated NSCLC patients could be comparable to that for EGFR-negative patients. To prolong the survival of EGFR-mutated NSCLC patients, appropriate selection and sequencing of EGFR for tyrosine kinase inhibitors, as well as immune checkpoint inhibitors, anti-tumor agents, and anti-angiogenic agents are important.
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Affiliation(s)
- Tomohiro Tamura
- Respiratory Center, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Takeshi Numata
- Departments of Respiratory Medicine and Surgery, National Hospital Organization Mito Medical Center, Ibarakimachi, Japan
| | - Hidetoshi Yanai
- Departments of Respiratory Medicine and Surgery, National Hospital Organization Mito Medical Center, Ibarakimachi, Japan
| | - Ryota Nakamura
- Departments of Respiratory Medicine and Surgery, National Hospital Organization Mito Medical Center, Ibarakimachi, Japan
| | - Toshihiro Shiozawa
- Division of Respiratory Medicine, Faculty of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroko Watanabe
- Division of Respiratory Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan
| | - Shinichiro Okauchi
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Japan
| | - Norihiro Kikuchi
- Division of Respiratory Medicine, National Hospital Organization Kasumigaura Medical Center, Tsuchiura, Japan
| | - Kunihiko Miyazaki
- Division of Respiratory Medicine, Ryugasaki Saiseikai Hospital, Ryugasaki, Japan
| | - Shigen Hayashi
- Division of Respiratory Medicine, Ibaraki Seinan Medical Center Hospital, Sakai, Japan
| | - Takaaki Yamashita
- Division of Respiratory Medicine, JA Toride Medical Center Hospital, Toride, Japan
| | - Koichi Kurishima
- Division of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Masaharu Inagaki
- Division of Thoracic Surgery, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Hiroaki Satoh
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Japan;
| | - Hiroichi Ishikawa
- Division of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Takayuki Kaburagi
- Respiratory Center, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Takeo Endo
- Departments of Respiratory Medicine and Surgery, National Hospital Organization Mito Medical Center, Ibarakimachi, Japan
| | - Toru Sakamoto
- Division of Respiratory Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan
| | - Nobuyuki Hizawa
- Division of Respiratory Medicine, Faculty of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
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Wakatsuki M, Makishima H, Mori Y, Kaneko T, Yasuda S, Okada N, Nakajima M, Murata K, Okonogi N, Aoki S, Ishikawa H, Yamada S. Clinical Outcomes of Carbon-Ion Radiotherapy for Large-Sized (≥4cm) Hepatocellular Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e348. [PMID: 37785207 DOI: 10.1016/j.ijrobp.2023.06.2418] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radical treatment options for bulky unresectable locally advanced hepatocellular carcinoma (HCC) are limited. The purpose of this study is to evaluate the safety and efficacy of carbon-ion radiotherapy (C-ion RT) for bulky (≥4cm) locally advanced HCC. MATERIALS/METHODS We performed a retrospective cohort study of patients with bulky (≥4cm) locally advanced HCC treated by C-ion RT between April 2000 and March 2020 in our institution. The eligibility criteria for this study were: (1) the treatment protocols of 45.0-48.0 Gy/2 fractions or 52.8-60.0 Gy/4 fractions, which proven the safety and efficacy in the past clinical trials; (2) Tumors within 3 intrahepatic lesions and with a maximum tumor diameter of 4 cm or greater; (3) N0M0 status; (4) an Eastern Cooperative Oncology Group performance status of 0 to 2; (5) controllable ascites; (6) Child-Pugh grade was A or B. Overall survival (OS), progression-free survival (PFS), and local control rate (LC) were calculated by the Kaplan-Meier method, and Cox regression analysis was used for multivariate analysis. Adverse events were evaluated by CTCAE ver. 5.0. JMP® 12 (SAS Institute Inc., Cary, NC, USA) was used for all analyses. We defined p < 0.05 as statistically significant. RESULTS A total of 187 patients met the criteria and were evaluated. The median patient age was 73 years (range, 37-90), and 139 of 187 patients were male. Child-Pugh grade was A in 163 patients and B in 24. Modified albumin-bilirubin (mALBI) grade was 1 in 96 patients, 2a in 50, and 2b in 41. The number of HCV-related HCC cases was in 80, HBV in 32 and non-B and non-C in 75. In 51 patients, identification of vascular invasion to the first-order branch of the portal vein and/or major hepatic vein was confirmed. The median maximum tumor diameter was 5.1 cm (4.0-13.5 cm). In 76 patients, C-ion RT were treated for recurrence. With a median follow-up period of 25.9 months (range, 1.1-215.1), 2-year overall survival, progression-free survival and local control rates were 68.3% (95% confidence interval [CI], 64.7-72.0%), 39.0% (95% CI, 35.2 - 42.8%) and 86.7% (95% CI, 84.7 - 89.7%), respectively. Late adverse events were observed in 3 patients (1.6%) with Grade 3 liver dysfunction and in 3 patients (1.6%) with Grade 3 skin disorders, but there were no cases of Grade 4 or higher. Multivariate analysis of prognostic factors for overall survival revealed that mALBI grade in 2b(HR:3.13, 1.97-4.78, p<0.0001), tumor status in recurrent treatment (HR:1.50, 1.02-2.21, p = 0.039), the number of tumors in 2 or more (HR:2.16, 1.01-2.17, p = 0.045), and maximum tumor diameter in larger than 6 cm (HR:2.34, 1.50-3.61, p = 0.0001) were the predominant prognostic factors, while age, presence of vascular invasion, AFP and DCP were not. CONCLUSION The safety and efficacy of C-ion RT for bulky (≥4cm) locally advanced HCC was demonstrated. These results suggested that C-ion RT may be a new treatment option for locally advanced bulky HCC with no curative treatment options.
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Affiliation(s)
- M Wakatsuki
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - H Makishima
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan; Departement of Radiation Oncology and Proton Medical Research Center, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Y Mori
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - T Kaneko
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan; Department of Radiation Oncology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - S Yasuda
- Department of Radiation Oncology, Chiba Rosai Hospital, Chiba, Japan
| | | | - M Nakajima
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - K Murata
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - N Okonogi
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - S Aoki
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - H Ishikawa
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - S Yamada
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
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6
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Mori Y, Wakatsuki M, Makishima H, Takashi K, Ishikawa H, Yasuda S, Okada N, Nakajima M, Murata K, Okonogi N, Aoki S, Yamada S. Long-Term Clinical Outcome of Carbon Ion Radio Therapy for Hepatocellular Carcinoma in the Caudate Lobe. Int J Radiat Oncol Biol Phys 2023; 117:e326-e327. [PMID: 37785158 DOI: 10.1016/j.ijrobp.2023.06.2373] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Surgical resection is the first-line treatment for hepatocellular carcinoma in the caudate lobe (caudate HCC), but it is often difficult due to the tumor's location. In addition, radiofrequency ablation and transcatheter arterial chemoembolization are also difficult for the same reason. This study aimed to evaluate the safety and efficacy of carbon-ion radiation therapy (C-ion RT) for caudate HCC. MATERIALS/METHODS We performed a retrospective cohort study of patients with hepatocellular carcinoma treated by C-ion RT between April 2000 and March 2020 in our institution. The eligibility criteria for this study were: (1) located mainly in the caudate lobe (2) the treatment protocols of 45.0-48.0 Gy/2 fractions or 52.8-60.0 Gy/4 fractions, which proved the safety and efficacy in the past clinical trials; (3) N0M0 status; (4) an Eastern Cooperative Oncology Group performance status (PS) of 0 to 2; (5) controllable ascites. The prescribed dose (Gy) used in this study is relative biological effectiveness (RBE) weighted dose. Overall survival (OS), progression-free survival (PFS), and local control rate (LC) were calculated by the Kaplan-Meier method. Adverse events were evaluated by NCI-CTCAE ver. 5.0. SPSS software version 27.0 (IBM Inc.) was used for all analyses. We defined p-value < 0.05 as statistically significant. RESULTS A total of 25 patients met the criteria and were evaluated. The median patient age was 73 years (range 58-89), and 21 of 25 patients were male. The number of patients with PS 0 was 22, PS 1 was 1, and PS 2 was 2. The number of HBV-related HCC cases was in 8, HCV-related HCC cases was in 11, and non-B and non-C cases was in 6. The median maximum tumor diameter was 3.0 cm (1.1-4.8 cm). In 6 patients, identification of vascular invasion to the main trunk of the portal vein and/or major hepatic vein was confirmed. The Child-Pugh (CP) grade was A in 21 patients and B in 4. The modified albumin-bilirubin (mALBI) grade 1 is in 17 patients, 2a in 4, 2b in 4. Prescribed doses were 45 Gy / 2 fr in 3 cases, 48 Gy / 2 fr in 12 cases, 52.8 Gy / 4 fr in 7 cases, and 60 Gy / 4 fr in 3 cases. With a median follow-up period of 43.6 months (range 0.3-85.0), 3-year OS, PFS, and LC were 74% (95% confidence interval [CI], 54.8-93.8%), 32% (95% CI, 11.8-51.4%), and 93% (95% CI, 79.4-106%), respectively. All patients had no Grade 2 or higher adverse events during the observation period. CONCLUSION The safety and efficacy of C-ion RT for caudate HCC were demonstrated. These results suggested that C-ion RT may be a promising treatment option for patients with caudate HCC.
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Affiliation(s)
- Y Mori
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - M Wakatsuki
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - H Makishima
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - K Takashi
- Yamagata university hospital, Yamagata, Japan
| | - H Ishikawa
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - S Yasuda
- Department of Radiation Oncology, Chiba Rosai Hospital, Chiba, Japan
| | | | - M Nakajima
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - K Murata
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - N Okonogi
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - S Aoki
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
| | - S Yamada
- QST Hospital, National Institutes for Quantum Science and Technology, Chiba, Japan
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7
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Okauchi S, Ohara G, Shiozawa T, Watanabe H, Numata T, Nakamura R, Tamura T, Kikuchi N, Miyazaki K, Hayashi S, Sakurai H, Yamashita T, Kurishima K, Inagaki M, Endo T, Ishikawa H, Kaburagi T, Satoh H, Sakamoto T, Hizawa N. Atezolizumab Monotherapy for Non-small Cell Lung Cancer Patients: An Observational Study in Ibaraki Group (ATTENTION-IBARAKI). In Vivo 2023; 37:2203-2209. [PMID: 37652502 PMCID: PMC10500511 DOI: 10.21873/invivo.13320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 07/01/2023] [Accepted: 07/07/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND/AIM Atezolizumab is a monoclonal antibody that targets programmed death-ligand 1 (PD-L1) expressed on cancer cells derived from various organs and antigen-presenting cells and is currently commonly used in combination with chemotherapy. We conducted a study to clarify the current status of response to atezolizumab monotherapy in clinical practice and clarify the factors that contribute to long-term response and survival. PATIENTS AND METHODS We conducted a retrospective review of patients with advanced non-small cell lung cancer (NSCLC) treated with atezolizumab monotherapy from April 2018 to March 2023 at 11 Hospitals. RESULTS The 147 patients evaluated had a progression-free survival (PFS) of 3.0 months and an overall survival of 7.0 months. Immune-related adverse events of any grade were observed in 13 patients (8.8%), grade 3 or higher in nine patients (6.1%), and grade 5 with pulmonary toxicity in one patient (0.7%). Favorable factors related to PFS were 'types of NSCLC other than adenocarcinoma'. Favorable factors for overall survival were 'performance status 0-1' and 'treatment lines up to 3'. There were 16 patients (10.9%) with PFS >1 year. No characteristic clinical findings were found in these 16 patients compared to the remaining 131 patients. CONCLUSION Efficacy and immune-related adverse events of NSCLC patients associated with atezolizumab monotherapy were comparable to those of previous clinical trial results. Knowledge of characteristics of patients who are most likely to benefit from atezolizumab monotherapy is a crucial step towards implementing appropriate prescribing.
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Affiliation(s)
- Shinichiro Okauchi
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Japan
| | - Gen Ohara
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Japan
| | - Toshihiro Shiozawa
- Division of Respiratory Medicine, Faculty of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hiroko Watanabe
- Division of Respiratory Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan
| | - Takeshi Numata
- Departments of Respiratory Medicine and Surgery, National Hospital Organization Mito Medical Center, Ibarakimachi, Japan
| | - Ryota Nakamura
- Departments of Respiratory Medicine and Surgery, National Hospital Organization Mito Medical Center, Ibarakimachi, Japan
| | - Tomohiro Tamura
- Respiratory Center, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Norihiro Kikuchi
- Division of Respiratory Medicine, National Hospital Organization Kasumigaura Medical Center, Tsuchiura, Japan
| | - Kunihiko Miyazaki
- Division of Respiratory Medicine, Ryugasaki Saiseikai Hospital, Ryugasaki, Japan
| | - Shigen Hayashi
- Division of Respiratory Medicine, Ibaraki Seinan Medical Center Hospital, Sakai, Japan
| | - Hirofumi Sakurai
- Division of Respiratory Medicine, Ibaraki Seinan Medical Center Hospital, Sakai, Japan
| | - Takaaki Yamashita
- Division of Respiratory Medicine, JA Toride Medical Center Hospital, Toride, Japan
| | - Koichi Kurishima
- Division of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Masaharu Inagaki
- Division of Thoracic Surgery, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Takeo Endo
- Division of Respiratory Medicine, Mito Medical Center, University of Tsukuba, Mito, Japan
| | - Hiroichi Ishikawa
- Division of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Takayuki Kaburagi
- Respiratory Center, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Hiroaki Satoh
- Departments of Respiratory Medicine and Surgery, National Hospital Organization Mito Medical Center, Ibarakimachi, Japan;
| | - Toru Sakamoto
- Division of Respiratory Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan
| | - Nobuyuki Hizawa
- Division of Respiratory Medicine, Faculty of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
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8
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Aoki H, Kawataki M, Kim K, Saito T, Inagaki Y, Shimokaze T, Ishikawa H, Toyoshima K. Reopening of ductus arteriosus in idiopathic premature constriction or closure of ductus arteriosus: A case series. J Neonatal Perinatal Med 2023; 16:75-80. [PMID: 36872790 DOI: 10.3233/npm-221013] [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: 03/06/2023]
Abstract
BACKGROUND There is no consensus on managing pregnancy when the fetus is diagnosed with idiopathic premature constriction or closure of the ductus arteriosus (PCDA). Knowing whether the ductus reopens is valuable information for managing idiopathic PCDA. We conducted a case-series study to investigate the natural perinatal course of idiopathic PCDA and examined factors associated with ductal reopening. METHODS We retrospectively collected information about the perinatal course and echocardiographic findings at our institution, which, on principle, does not determine delivery timing based on fetal echocardiographic results. We also examined perinatal factors related to the reopening of the ductus arteriosus. RESULTS Thirteen cases of idiopathic PCDA were included in the analysis. The ductus reopened in 38% of cases. Among cases diagnosed in < 37 weeks of gestation, 71% reopened, which was confirmed seven days after diagnosis (interquartile range 4-7). Diagnosis earlier in gestation was associated with ductal reopening (p = 0.006). Two cases (15%) developed persistent pulmonary hypertension. No fetal hydrops or death occurred. CONCLUSIONS The ductus is likely to reopen when prenatally diagnosed before 37 weeks gestation. There were no complications due to our pregnancy management policy. In idiopathic PCDA, especially if the prenatal diagnosis is made before 37 weeks of gestational age, continuing the pregnancy with careful monitoring of the fetus's well-being is recommended.
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Affiliation(s)
- H Aoki
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - M Kawataki
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - K Kim
- Department of Cardiology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - T Saito
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - Y Inagaki
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - T Shimokaze
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - H Ishikawa
- Department of Obstetrics and Gynecology, Kanagawa Children's Medical Center, Yokohama, Japan
| | - K Toyoshima
- Department of Neonatology, Kanagawa Children's Medical Center, Yokohama, Japan
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9
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Hirose Y, Akashi Y, Sun Y, Notake S, Ueda A, Kato D, Muramatsu S, Ishikawa H, Suzuki H. Diagnostic performance of microscopic stool examination in Campylobacter infection performed by different medical specialties. J Gen Fam Med 2023; 24:102-109. [PMID: 36909784 PMCID: PMC10000277 DOI: 10.1002/jgf2.596] [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: 06/07/2022] [Revised: 10/29/2022] [Accepted: 11/13/2022] [Indexed: 11/29/2022] Open
Abstract
Background Microscopic examination of stool samples can contribute to the early diagnosis of Campylobacter gastroenteritis. However, it is unclear whether the diagnostic performance is reliable when performed by physicians. Methods This prospective study included fresh stool samples collected from patients with gastroenteritis between August 2018 and March 2020. The samples were used for microscopic examination through Gram staining. Two physicians, a clinical laboratory technician, and microbiologists performed the examinations. In addition, antigen tests (QuickNavi-Campylobacter; Denka Co., Ltd.) were evaluated for the samples collected between May 2019 and March 2020. Infection with Campylobacter spp. was confirmed when stool cultures or polymerase chain reaction tests provided positive results. Results Microscopic examination was performed on 205 samples, of which 46 (22.4%) were positive for Campylobacter spp. For the microscopic examination, the sensitivity and specificity were 53.5% and 98.1% for physician A, 46.7% and 96.2% for physician B, 63.0% and 100% for the clinical laboratory technician, and 67.4% and 100% for microbiologists, respectively. The antigen testing was evaluated in 131 of the 205 samples and showed a sensitivity of 93.3% and specificity of 99.0%. Conclusions Microscopic examination of the stool samples showed high specificity. The sensitivity when the examinations were performed by the physicians was insufficient. The rapid antigen tests can reliably detect Campylobacter spp. in stool samples.
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Affiliation(s)
- Yumi Hirose
- Department of General Medicine and Primary Care Tsukuba Medical Center Hospital Tsukuba Japan
| | - Yusaku Akashi
- Division of Infectious Diseases, Department of Medicine Tsukuba Medical Center Hospital Tsukuba Japan.,Akashi Clinic of Internal Medicine Clinic Osaka Japan.,Department of Infectious Diseases, Faculty of Medicine University of Tsukuba Tsukuba Japan
| | - Yu Sun
- Department of General Medicine and Primary Care Tsukuba Medical Center Hospital Tsukuba Japan.,Graduate School of Comprehensive Human Sciences University of Tsukuba Tsukuba Japan.,Health Services Research and Development Center University of Tsukuba Tsukuba Japan
| | - Shigeyuki Notake
- Department of Clinical Laboratory Tsukuba Medical Center Hospital Tsukuba Japan
| | - Atsuo Ueda
- Department of Clinical Laboratory Tsukuba Medical Center Hospital Tsukuba Japan
| | - Daisuke Kato
- Research & Development Division, Reagent R&D Department Gosen site, Denka Co., Ltd. Gosen Japan
| | - Shino Muramatsu
- Research & Development Division, Reagent R&D Department Gosen site, Denka Co., Ltd. Gosen Japan
| | - Hiroichi Ishikawa
- Department of Respiratory Medicine Tsukuba Medical Center Hospital Tsukuba Japan
| | - Hiromichi Suzuki
- Division of Infectious Diseases, Department of Medicine Tsukuba Medical Center Hospital Tsukuba Japan.,Department of Infectious Diseases, Faculty of Medicine University of Tsukuba Tsukuba Japan
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10
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Ishikawa H, Satoh H, Hizawa N. Tracheobronchial adenoid cystic carcinoma mimicking bronchial asthma. J Postgrad Med 2023; 69:56-58. [PMID: 36571332 PMCID: PMC9997610 DOI: 10.4103/jpgm.jpgm_201_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- H Ishikawa
- Division of Respiratory Medicine, Department of Internal Medicine, University of Tsukuba Hospital, Ibaraki, Japan
| | - H Satoh
- Division of Respiratory Medicine, Department of Internal Medicine, University of Tsukuba Hospital, Ibaraki, Japan
| | - N Hizawa
- Division of Respiratory Medicine, Department of Internal Medicine, University of Tsukuba Hospital, Ibaraki, Japan
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11
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Kuyama S, Yoshioka H, Kaneda H, Kataoka Y, Miura S, Katakami N, Yamanaka Y, Tamiya A, Yamada T, Yokoyama T, Hara S, Tanaka H, Fujisaka Y, Nakamura A, Azuma K, Namba M, Hata A, Sawa K, Ishikawa H, Kurata T. 330P A real-world multi-center prospective observational study of atezolizumab (Atezo) + bevacizumab (Bev) + carboplatin (CBDCA) + paclitaxel (PTX) (ABCP) in patients (pts) with advanced EGFR-mutated (EGFRm) NSCLC after EGFR-TKIs failure. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
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12
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Murofushi K, Murofushi W, Komazawa M, Ohnishi K, Shimizuguchi T, Ito K, Hayakawa S, Ishikawa H. Preliminary Study on Establishing a Heart Rate Variability–Based Method for Objectively Evaluating Bone Metastasis Pain. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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13
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Nagumo Y, Kimura T, Ishikawa H, Sekino Y, Maruo K, Mathis B, Takemura M, Kageyama Y, Ushijima H, Kawai T, Yamashita H, Azuma H, Naiki T, Kobayashi Y, Inokuchi J, Osawa T, Kita Y, Tsuzuki T, Hashimoto K, Nishiyama H. 1740P Bladder preservation therapy in combination with atezolizumab and radiation therapy for invasive bladder cancer (BPT-ART): An open-label, single-arm, multicenter, phase II trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1818] [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: 11/01/2022] Open
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14
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Ando T, Nakashima K, Yoshita H, Sakumura M, Nomura M, Muto M, Fujii H, Horie Y, Takeda H, Yoshii T, Tahara Y, Katada C, Yoshimura K, Ishikawa H, Hosokawa A. P-108 A phase II study of weekly paclitaxel in patients with advanced or recurrent esophageal cancer who had previously received docetaxel-containing chemotherapy. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.198] [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: 11/26/2022] Open
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15
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Hyodo K, Masuko H, Oshima H, Shigemasa R, Kitazawa H, Kanazawa J, Iijima H, Ishikawa H, Kodama T, Nomura A, Kagohashi K, Satoh H, Saito T, Sakamoto T, Hizawa N. Common exacerbation-prone phenotypes across asthma and chronic obstructive pulmonary disease (COPD). PLoS One 2022; 17:e0264397. [PMID: 35312711 PMCID: PMC8936473 DOI: 10.1371/journal.pone.0264397] [Citation(s) in RCA: 2] [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: 09/17/2021] [Accepted: 02/10/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic inflammatory airway diseases, including asthma and chronic obstructive pulmonary disease (COPD), are complex syndromes with diverse clinical symptoms due to multiple pathophysiological conditions. In this study, using common and shared risk factors for the exacerbation of asthma and COPD, we sought to clarify the exacerbation-prone phenotypes beyond disease labels, and to specifically investigate the role of the IL4RA gene polymorphism, which is related to type 2 inflammation, in these exacerbation-prone phenotypes. METHODS The study population comprised patients with asthma (n = 117), asthma-COPD overlap (ACO; n = 37) or COPD (n = 48) and a history of exacerbation within the previous year. Cluster analyses were performed using factors associated with both asthma and COPD exacerbation. The association of the IL4RA gene polymorphism rs8832 with each exacerbation-prone phenotype was evaluated by multinomial logistic analyses using non-asthma non-COPD healthy adults as controls (n = 1,529). In addition, the genetic influence of rs8832 was also examined in asthma patients with allergic rhinitis and no history of exacerbation (n = 130). RESULTS Two-step cluster analyses identified five clusters that did not necessarily correspond to the diagnostic disease labels. Cluster 1 was characterized by high eosinophil counts, cluster 2 was characterized by smokers with impaired lung function, cluster 3 was characterized by the presence of gastroesophageal reflux, cluster 4 was characterized by non-allergic females, and cluster 5 was characterized by allergic rhinitis and elevated total immunoglobulin E levels. A significant association with rs8832 was observed for cluster 5 (odds ratio, 3.88 (1.34-11.26), p = 0.013) and also for the type 2 exacerbation-prone phenotypes (clusters 1 and 5: odds ratio, 2.73 (1.45-5.15), p = 1.9 × 10-3). DISCUSSION Our results indicated that the clinical heterogeneity of disease exacerbation may reflect the presence of common exacerbation-prone endotypes across asthma and COPD, and may support the use of the treatable traits approach for the prevention of exacerbations in patients with chronic inflammatory airway diseases.
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Affiliation(s)
- Kentaro Hyodo
- Department of Pulmonary Medicine, University of Tsukuba, Ibaraki, Japan.,Department of Respiratory Medicine, National Hospital Organization Ibaraki Higashi National Hospital, Ibaraki, Japan
| | - Hironori Masuko
- Department of Pulmonary Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hisayuki Oshima
- Department of Pulmonary Medicine, University of Tsukuba, Ibaraki, Japan
| | - Rie Shigemasa
- Department of Pulmonary Medicine, University of Tsukuba, Ibaraki, Japan
| | - Haruna Kitazawa
- Department of Pulmonary Medicine, University of Tsukuba, Ibaraki, Japan
| | - Jun Kanazawa
- Department of Respiratory Medicine, National Hospital Organization Ibaraki Higashi National Hospital, Ibaraki, Japan
| | - Hiroaki Iijima
- Department of Respiratory Medicine, Tsukuba Medical Center, Ibaraki, Japan
| | - Hiroichi Ishikawa
- Department of Respiratory Medicine, Tsukuba Medical Center, Ibaraki, Japan
| | - Takahide Kodama
- Department of Respiratory Medicine, Ryugasaki Saiseikai Hospital, Ibaraki, Japan
| | - Akihiro Nomura
- Department of Respiratory Medicine, Ibaraki Seinan Medical Center Hospital, Ibaraki, Japan
| | | | - Hiroaki Satoh
- Department of Pulmonary Medicine, University of Tsukuba, Ibaraki, Japan
| | - Takefumi Saito
- Department of Respiratory Medicine, National Hospital Organization Ibaraki Higashi National Hospital, Ibaraki, Japan
| | - Tohru Sakamoto
- Department of Pulmonary Medicine, University of Tsukuba, Ibaraki, Japan
| | - Nobuyuki Hizawa
- Department of Pulmonary Medicine, University of Tsukuba, Ibaraki, Japan
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16
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Naito A, Kiyasu Y, Akashi Y, Sugiyama A, Michibuchi M, Takeuchi Y, Notake S, Nakamura K, Ishikawa H, Suzuki H. The evaluation of the utility of the GENECUBE HQ SARS-CoV-2 for anterior nasal samples and saliva samples with a new rapid examination protocol. PLoS One 2021; 16:e0262159. [PMID: 34972195 PMCID: PMC8719657 DOI: 10.1371/journal.pone.0262159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 12/16/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION GENECUBE® is a rapid molecular identification system, and previous studies demonstrated that GENECUBE® HQ SARS-CoV-2 showed excellent analytical performance for the detection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) with nasopharyngeal samples. However, other respiratory samples have not been evaluated. METHODS This prospective comparison between GENECUBE® HQ SARS-CoV-2 and reference real-time reverse transcriptase polymerase chain reaction (RT-PCR) was performed for the detection of SARS-CoV-2 using anterior nasal samples and saliva samples. Additionally, we evaluated a new rapid examination protocol using GENECUBE® HQ SARS-CoV-2 for the detection of SARS-CoV-2 with saliva samples. For the rapid protocol, in the preparation of saliva samples, purification and extraction processes were adjusted, and the total process time was shortened to approximately 35 minutes. RESULTS For 359 anterior nasal samples, the total-, positive-, and negative concordance of the two assays was 99.7% (358/359), 98.1% (51/52), and 100% (307/307), respectively. For saliva samples, the total-, positive-, and negative concordance of the two assays was 99.6% (239/240), 100% (56/56), and 99.5% (183/184), respectively. With the new protocol, total-, positive-, and negative concordance of the two assays was 98.8% (237/240), 100% (56/56), and 98.4% (181/184), respectively. In all discordance cases, SARS-CoV-2 was detected by additional molecular examinations. CONCLUSION GENECUBE® HQ SARS-CoV-2 provided high analytical performance for the detection of SARS-CoV-2 in anterior nasal samples and saliva samples.
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Affiliation(s)
- Asami Naito
- Tsukuba i-Laboratory LLP, Tsukuba, Ibaraki, Japan
| | - Yoshihiko Kiyasu
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
- Department of Infectious Diseases, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Yusaku Akashi
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
- Akashi Internal Medicine Clinic, Kashiwara, Osaka, Japan
| | - Akio Sugiyama
- Diagnostic System Department, TOYOBO Co., Ltd., Kita-ku, Osaka, Japan
| | | | - Yuto Takeuchi
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
- Department of Infectious Diseases, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
| | - Shigeyuki Notake
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
| | - Koji Nakamura
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
| | - Hiroichi Ishikawa
- Department of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
| | - Hiromichi Suzuki
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, Tsukuba, Ibaraki, Japan
- Department of Infectious Diseases, University of Tsukuba Hospital, Tsukuba, Ibaraki, Japan
- Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan
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17
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Akashi Y, Kiyasu Y, Takeuchi Y, Kato D, Kuwahara M, Muramatsu S, Ueda A, Notake S, Nakamura K, Ishikawa H, Suzuki H. Evaluation and clinical implications of the time to a positive results of antigen testing for SARS-CoV-2. J Infect Chemother 2021; 28:248-251. [PMID: 34799237 PMCID: PMC8577995 DOI: 10.1016/j.jiac.2021.10.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 10/21/2021] [Accepted: 10/30/2021] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Antigen tests for severe acute respiratory coronavirus 2 sometimes show positive lines earlier than their specified read time, although the implication of getting the results at earlier time is not well understood. METHODS We prospectively collected additional nasopharyngeal samples from patients who had already tested positive for SARS-CoV-2 by reverse transcription PCR. The swab was used for an antigen test, QuickNavi™-COVID19 Ag, and the time periods to get positive results were measured. RESULTS In 84 of 96 (87.5%) analyzed cases, the results of QuickNavi™-COVID19 Ag were positive. The time to obtain positive results was 15.0 seconds in median (inter quartile range: 12.0-33.3, range 11-736) and was extended in samples with higher cycle thresholds (p < 0.001). Positive lines appeared within a minute in 85.7% of cases and within 5 min in 96.4%. CONCLUSION QuickNavi™-COVID19 Ag immediately showed positive results in most cases, and the time to a positive reaction may have indicated the viral load.
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Affiliation(s)
- Yusaku Akashi
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 3058558, Japan; Akashi Internal Medicine Clinic, 3-1-63 Asahigaoka, Kashiwara, Osaka, 5820026, Japan.
| | - Yoshihiko Kiyasu
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 3058558, Japan; Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 3058576, Japan.
| | - Yuto Takeuchi
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 3058558, Japan; Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 3058576, Japan.
| | - Daisuke Kato
- Research & Development Division, Reagent R&D Department, Gosen site, Denka Co., Ltd., 1-2-2 Minamihoncho, Gosen-shi, Niigata, 9591695, Japan.
| | - Miwa Kuwahara
- Research & Development Division, Reagent R&D Department, Gosen site, Denka Co., Ltd., 1-2-2 Minamihoncho, Gosen-shi, Niigata, 9591695, Japan.
| | - Shino Muramatsu
- Research & Development Division, Reagent R&D Department, Gosen site, Denka Co., Ltd., 1-2-2 Minamihoncho, Gosen-shi, Niigata, 9591695, Japan.
| | - Atsuo Ueda
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 3058558, Japan.
| | - Shigeyuki Notake
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 3058558, Japan.
| | - Koji Nakamura
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 3058558, Japan.
| | - Hiroichi Ishikawa
- Department of Respiratory Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 3058558, Japan.
| | - Hiromichi Suzuki
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 3058558, Japan; Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 3058576, Japan; Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058575, Japan.
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18
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Suzuki H, Akashi Y, Ueda A, Kiyasu Y, Takeuchi Y, Maehara Y, Ochiai Y, Okuyama S, Notake S, Nakamura K, Ishikawa H. Diagnostic performance of a novel digital immunoassay (RapidTesta SARS-CoV-2): A prospective observational study with nasopharyngeal samples. J Infect Chemother 2021; 28:78-81. [PMID: 34736814 PMCID: PMC8549190 DOI: 10.1016/j.jiac.2021.10.024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/06/2021] [Accepted: 10/24/2021] [Indexed: 12/31/2022]
Abstract
Introduction Digital immunoassays are generally regarded as superior tests for the detection of infectious disease pathogens, but there have been insufficient data concerning SARS-CoV-2 immunoassays. Methods We prospectively evaluated a novel digital immunoassay (RapidTesta SARS-CoV-2). Two nasopharyngeal samples were simultaneously collected for antigen tests and Real-time RT-PCR. Results During the study period, 1127 nasopharyngeal samples (symptomatic patients: 802, asymptomatic patients: 325) were evaluated. For digital immunoassay antigen tests, the sensitivity was 78.3% (95% CI: 67.3%–87.1%) and the specificity was 97.6% (95% CI: 96.5%–98.5%). When technicians visually analyzed the antigen test results, the sensitivity was 71.6% (95% CI: 59.9%–81.5%) and the specificity was 99.2% (95% CI: 98.5%–99.7%). Among symptomatic patients, the sensitivity was 89.4% (95% CI; 76.9%–96.5%) with digital immunoassay antigen tests, and 85.1% (95% CI; 71.7%–93.8%) with visually analyzed the antigen test, respectively. Conclusions The sensitivity of digital immunoassay antigen tests was superior to that of visually analyzed antigen tests, but the rate of false-positive results increased with the introduction of a digital immunoassay device.
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Affiliation(s)
- Hiromichi Suzuki
- Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan; Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan; Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.
| | - Yusaku Akashi
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan; Akashi Internal Medicine Clinic, 3-1-63 Asahigaoka, Kashiwara, Osaka, 582-0026, Japan.
| | - Atsuo Ueda
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
| | - Yoshihiko Kiyasu
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan; Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.
| | - Yuto Takeuchi
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan; Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.
| | - Yuta Maehara
- Sekisui Medical Co., Ltd. Research & Development Division, Urban Net Nihonbashi 2-chome Building, 2-1-3 Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan.
| | - Yasushi Ochiai
- Sekisui Medical Co., Ltd. Research & Development Division, Urban Net Nihonbashi 2-chome Building, 2-1-3 Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan.
| | - Shinya Okuyama
- Sekisui Medical Co., Ltd. Research & Development Division, Urban Net Nihonbashi 2-chome Building, 2-1-3 Nihonbashi, Chuo-ku, Tokyo, 103-0027, Japan.
| | - Shigeyuki Notake
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
| | - Koji Nakamura
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
| | - Hiroichi Ishikawa
- Department of Respiratory Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan.
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Otsuka K, Ishikawa H, Yamaura H, Shirasawa K, Kasayuki N. Epicardial adipose tissue volume is associated with low-attenuation plaque volume in subjects with or without increased visceral fat: a 3-vessel coronary artery analysis with CT angiography. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Low-attenuation plaque (LAP) with a CT value of less than or equal 30 HU on coronary CT angiography (CCTA) is a marker of high-risk plaque features that leads to future acute coronary syndromes. Perivascular and epicardial adipose tissue (EAT) have been shown to be associated with progression of high-risk coronary plaques through metabolic and inflammatory mechanisms. However, association of EAT with LAP volume in three coronary arteries in subjects with or without visceral obesity remain unclear.
Aims
This study aimed to investigate the association of EAT volume (EAV) and coronary 3-vessel LAP volume in subjects with or without visceral obesity who underwent CCTA.
Methods
Patients who underwent CCTA without known coronary artery disease were included in the study (525 patients). Study subjects were classified as having non-obstructive or obstructive coronary artery disease according to the degree of coronary artery stenosis on CCTA. The plaque volume and EAV of the main vessel of the left anterior descending artery, left circumflex artery, and right coronary artery were measured with VINCENT software. Coronary plaque composition was classified as calcified plaque (CP, >150HU), noncalcified plaque (NCP, 30–150HU), and Lap (<30HU). The %LAP volume of the three coronary arteries was classified into quartiles. Multiple logistic regression analysis was used to analyze the factors associated with the %LAP volume.
Results
Compared with subjects without increase visceral fat, subjects with increased visceral fat had a significantly higher BMI, a greater total plaque volume, a greater total %LAP volume, a greater EAV, and a lower mean CT value of EAT. A significant correlation was observed between EAV and %LAP volume (R=0.24, p<0.001). EAV (odds ratio; 1.83, 95% confidence interval 1.071–3.141, p-value 0.027) and type 2 diabetes mellitus (odds ratio 1.76, 95%confidence interval 1.042–3.000, p-value 0.034) appeared to be independent predictors of %LAP volume (Q4), when adjusted by age, gender, BMI>25 kg/m2, visceral fat >100cm2, LogCRP, coronary artery calcium score>300, and obstructive coronary artery disease requiring revascularization.
Conclusion
This study suggests that LAP volume, which reflects the high-risk plaques in the three coronary arteries, is associated with EAV in subjects with or without increased visceral fat. Further research is needed whether pharmacological therapeutic intervention enables the prevention of coronary plaque progression and destabilization through the reduction of EAV in patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Otsuka
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
| | - H Ishikawa
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
| | - H Yamaura
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
| | - K Shirasawa
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
| | - N Kasayuki
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
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20
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Otsuka K, Ishikawa H, Kono Y, Shirasawa K, Hirata K, Kasayuki N. Clinical significance of aortic arch plaques simultaneously assessed with coronary atherosclerosis on cardiovascular outcomes in patients undergoing coronary CT angiography. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0158] [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
Aims
Computed tomography (CT) coronary angiography is a useful diagnostic imaging modality in assessing presence, severity, and extent of coronary artery disease (CAD). Aortic arch plaques have been shown to be an underlying cause of embolic stroke and also related to increased risk of cardiovascular events. Yet, conventional CTCA imaging protocol does not include aortic arch for the reduction of radiation exposure. This study aimed to investigate prevalence of aortic arch plaques simultaneously assessed by CTCA and their clinical significance in combination with the presence of obstructive CAD for prediction of CVD events in patients with suspected CAD.
Methods
This study consisted of 310 (mean age, 66 years old, 42% female) patients with suspected CAD undergoing CTCA between 2017 and 2019. All CTCA examination was performed with 320-row detector scanner using ECG-triggered prospective gating method. Aortic arch images were simultaneously acquired during CTCA scanning without an increase of contrast media. Using Agatston method, coronary artery calcium score (CACS) was categorized into either of the groups having CACS of 0, 0–99, 100–299, or more than 300. The presence of CAD was reported as non-obstructive or obstructive CAD. High-risk featured aortic plaque was defined as large plaques >4 mm in thickness showing ulceration or protrusion. A composite event of cardiovascular disease, including all-cause mortality, non-fatal myocardial infarction, unplanned hospitalization requiring revascularization or stroke was defined as the primary endpoint.
Results
Patients having CACS of 0, 0–99, 100–299, and >300 were found in 41%, 24%, 15%, 20%%, respectively, where obstructive CAD was diagnosed in 11%. Aortic HRPs in ascending aorta, aortic arch, and thoracic descending aorta were observed in 1.6%, 6.9%, and 15%, respectively. During a mean follow-up period of 2.2 years, the primary endpoint was observed in 27 patients (8.7%). Cox regression hazard model demonstrated an independent association of aortic arch high-risk plaques (HR; 3.2, 95% CI; 1.20–8.64, p=0.02) and obstructive CAD (HR; 3.3, 95% CI; 1.45–7.92, P=0.005) when adjusted by age, CACS, and chronic kidney disease. Kaplan-Meier curve analysis showed a worse outcome of patients with aortic HRP and obstructive CAD compared to those without aortic plaques and obstructive CAD (p<0.001).
Conclusion
This study demonstrated an independent association of aortic arch high-risk featured plaques with CVD events. Further study is warranted whether pharmacological interventional therapies can reduce future CVD risks in patients with CAD and aortic arch plaques.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Otsuka
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
| | - H Ishikawa
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
| | - Y Kono
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
| | - K Shirasawa
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
| | - K Hirata
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
| | - N Kasayuki
- Kashibaseiki Hospital, Cardiovascular Medicine, Kashiba, Japan
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21
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Kurihara Y, Kiyasu Y, Akashi Y, Takeuchi Y, Narahara K, Mori S, Takeshige T, Notake S, Ueda A, Nakamura K, Ishikawa H, Suzuki H. The evaluation of a novel digital immunochromatographic assay with silver amplification to detect SARS-CoV-2. J Infect Chemother 2021; 27:1493-1497. [PMID: 34294528 PMCID: PMC8275475 DOI: 10.1016/j.jiac.2021.07.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/22/2021] [Accepted: 07/08/2021] [Indexed: 11/26/2022]
Abstract
Introduction Rapid antigen tests are convenient for diagnosing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); however, they have lower sensitivities than nucleic acid amplification tests. In this study, we evaluated the diagnostic performance of Quick Chaser® Auto SARS-CoV-2, a novel digital immunochromatographic assay that is expected to have higher sensitivity than conventional antigen tests. Methods A prospective observational study was conducted between February 8 and March 24, 2021. We simultaneously obtained two nasopharyngeal samples, one for evaluation with the QuickChaser® Auto SARS-CoV-2 antigen test and the other for assessment with reverse transcription PCR (RT-PCR), considered the gold-standard reference test. The limit of detection (LOD) of the new antigen test was compared with those of four other commercially available rapid antigen tests. Results A total of 1401 samples were analyzed. SARS-CoV-2 was detected by reference RT-PCR in 83 (5.9%) samples, of which 36 (43.4%) were collected from symptomatic patients. The sensitivity, specificity, positive predictive value, and negative predictive value were 74.7% (95% confidence interval (CI): 64.0–83.6%), 99.8% (95% CI: 99.5–100%), 96.9% (95% CI: 89.2–99.6%), and 98.4% (95% CI: 97.6–99.0%), respectively. When limited to samples with a cycle threshold (Ct) < 30 or those from symptomatic patients, the sensitivity increased to 98.3% and 88.9%, respectively. The QuickChaser® Auto SARS-CoV-2 detected 34–120 copies/test, which indicated greater sensitivity than the other rapid antigen tests. Conclusions QuickChaser® Auto SARS-CoV-2 showed sufficient sensitivity and specificity in clinical samples of symptomatic patients. The sensitivity was comparable to RT-PCR in samples with Ct < 30.
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Affiliation(s)
- Yoko Kurihara
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan; Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Yoshihiko Kiyasu
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan; Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan.
| | - Yusaku Akashi
- Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan; Akashi Internal Medicine Clinic, 3-1-63 Asahigaoka, Kashiwara, Osaka, 582-0026, Japan
| | - Yuto Takeuchi
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan; Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan
| | - Kenji Narahara
- Mizuho Medy Co., Ltd., 5-4 Fujinoki-machi, Tosu City, Saga, 841-0048, Japan
| | - Sunao Mori
- Mizuho Medy Co., Ltd., 5-4 Fujinoki-machi, Tosu City, Saga, 841-0048, Japan
| | - Tomonori Takeshige
- Mizuho Medy Co., Ltd., 5-4 Fujinoki-machi, Tosu City, Saga, 841-0048, Japan
| | - Shigeyuki Notake
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Atsuo Ueda
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Koji Nakamura
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Hiroichi Ishikawa
- Department of Respiratory Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Hiromichi Suzuki
- Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan; Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan
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22
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Kiyasu Y, Takeuchi Y, Akashi Y, Kato D, Kuwahara M, Muramatsu S, Notake S, Ueda A, Nakamura K, Ishikawa H, Suzuki H. Prospective analytical performance evaluation of the QuickNavi™-COVID19 Ag for asymptomatic individuals. J Infect Chemother 2021; 27:1489-1492. [PMID: 34301485 PMCID: PMC8266545 DOI: 10.1016/j.jiac.2021.07.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/29/2021] [Accepted: 07/05/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Antigen testing may help screen for and detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections in asymptomatic individuals. However, limited data regarding the diagnostic performance of antigen tests for this group are available. METHODS We used clinical samples to prospectively evaluate the analytical and clinical performance of the antigen test QuickNavi™-COVID19 Ag. This study was conducted at a PCR center between October 7, 2020 and January 9, 2021. Two nasopharyngeal samples per patient were obtained with flocked swabs; one was used for the antigen test, and the other for real-time reverse transcription PCR (RT-PCR). The diagnostic performance of the antigen test was compared between asymptomatic and symptomatic patients, and the RT-PCR results were used as a reference. RESULTS Among the 1934 collected samples, 188 (9.7%) demonstrated detection of SARS-CoV-2 by real-time RT-PCR; 76 (40.4%) of these 188 samples were from asymptomatic individuals, and over half of the total samples were asymptomatic (1073; 55.5%). The sensitivity of the antigen test was significantly lower for the asymptomatic group than for symptomatic patients (67.1% vs. 89.3%, respectively, p < 0.001). The specificity was 100% for both groups, and no false positives were observed among all 1934 samples. The median cycle threshold value for the asymptomatic group was significantly higher than that of the symptomatic group (24 vs. 20, p < 0.001). CONCLUSIONS The QuickNavi™-COVID19 Ag showed lower sensitivity for the asymptomatic group than for symptomatic patients. However, its specificity was consistently high, and no false positives were found in this study.
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Affiliation(s)
- Yoshihiko Kiyasu
- Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan; Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan.
| | - Yuto Takeuchi
- Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan; Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan.
| | - Yusaku Akashi
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan; Akashi Internal Medicine Clinic, 3-1-63 Asahigaoka, Kashiwara, Osaka, 582-0026, Japan.
| | - Daisuke Kato
- Denka Co., Ltd. Gosen Site, Research & Development Division, Reagent R&D Department, 1-2-2 Minami-hon-cho, Gosen-shi, Niigata, 959-1695, Japan.
| | - Miwa Kuwahara
- Denka Co., Ltd. Gosen Site, Research & Development Division, Reagent R&D Department, 1-2-2 Minami-hon-cho, Gosen-shi, Niigata, 959-1695, Japan.
| | - Shino Muramatsu
- Denka Co., Ltd. Gosen Site, Research & Development Division, Reagent R&D Department, 1-2-2 Minami-hon-cho, Gosen-shi, Niigata, 959-1695, Japan.
| | - Shigeyuki Notake
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
| | - Atsuo Ueda
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
| | - Koji Nakamura
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
| | - Hiroichi Ishikawa
- Department of Respiratory Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan.
| | - Hiromichi Suzuki
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan; Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
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23
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Takeuchi Y, Akashi Y, Kato D, Kuwahara M, Muramatsu S, Ueda A, Notake S, Nakamura K, Ishikawa H, Suzuki H. Diagnostic performance and characteristics of anterior nasal collection for the SARS-CoV-2 antigen test: a prospective study. Sci Rep 2021; 11:10519. [PMID: 34006975 PMCID: PMC8131686 DOI: 10.1038/s41598-021-90026-8] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [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: 03/21/2021] [Accepted: 05/06/2021] [Indexed: 01/07/2023] Open
Abstract
The clinical utility of antigen test using anterior nasal samples has not been well evaluated. We conducted a prospective study in a drive-through testing site located at a PCR center to evaluate the diagnostic performance of the antigen test QuickNavi-COVID19 Ag using anterior nasal samples and to compare the degrees of coughs or sneezes induction and the severity of pain between anterior nasal collection and nasopharyngeal collection. The study included a total of 862 participants, of which 91.6% were symptomatic. The median duration from symptom onset to sample collection was 2.0 days. Fifty-one participants tested positive for severe acute respiratory syndrome coronavirus 2 on reverse transcription PCR (RT-PCR) with nasopharyngeal samples, and all of them were symptomatic. In comparison to the findings of RT-PCR, the antigen test using anterior nasal samples showed 72.5% sensitivity (95% confidence interval [CI] 58.3-84.1%) and 100% specificity (95% CI 99.3-100%). Anterior nasal collection was associated with a significantly lower degree of coughs or sneezes induction and the severity of pain in comparison to nasopharyngeal collection (p < 0.001). The antigen test using anterior nasal samples showed moderate sensitivity in symptomatic patients who were at the early stages of the disease course but was less painful and induced fewer coughs or sneezes.
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Affiliation(s)
- Yuto Takeuchi
- Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 3058576, Japan.,Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 3058558, Japan
| | - Yusaku Akashi
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 3058558, Japan. .,Akashi Internal Medicine Clinic, 3-1-63 Asahigaoka, Kashiwara, Osaka, 5820026, Japan.
| | - Daisuke Kato
- Gosen Site, Research and Development Division, Reagent R&D Department, Denka Co., Ltd., 1-2-2 Minami-hon-cho, Gosen-shi, Niigata, 9591695, Japan
| | - Miwa Kuwahara
- Gosen Site, Research and Development Division, Reagent R&D Department, Denka Co., Ltd., 1-2-2 Minami-hon-cho, Gosen-shi, Niigata, 9591695, Japan
| | - Shino Muramatsu
- Gosen Site, Research and Development Division, Reagent R&D Department, Denka Co., Ltd., 1-2-2 Minami-hon-cho, Gosen-shi, Niigata, 9591695, Japan
| | - Atsuo Ueda
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 3058558, Japan
| | - Shigeyuki Notake
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 3058558, Japan
| | - Koji Nakamura
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 3058558, Japan
| | - Hiroichi Ishikawa
- Department of Respiratory Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 3058558, Japan
| | - Hiromichi Suzuki
- Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 3058576, Japan.,Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 3058558, Japan.,Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 3058575, Japan
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24
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Takeuchi Y, Akashi Y, Kato D, Kuwahara M, Muramatsu S, Ueda A, Notake S, Nakamura K, Ishikawa H, Suzuki H. The evaluation of a newly developed antigen test (QuickNavi™-COVID19 Ag) for SARS-CoV-2: A prospective observational study in Japan. J Infect Chemother 2021; 27:890-894. [PMID: 33727026 PMCID: PMC7931724 DOI: 10.1016/j.jiac.2021.02.029] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/13/2021] [Accepted: 02/27/2021] [Indexed: 01/25/2023]
Abstract
Introduction Several antigen tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed worldwide, but their clinical utility has not been well established. In this study, we evaluated the analytical and clinical performance of QuickNavi™-COVID19 Ag, a newly developed antigen test in Japan. Methods This prospective observational study was conducted at a PCR center between October 7 and December 5, 2020. The included patients were referred from a local public health center and 89 primary care facilities. We simultaneously obtained two nasopharyngeal samples with flocked swabs; one was used for the antigen test and the other for real-time reverse transcription PCR (RT-PCR). Using the results of real-time RT-PCR as a reference, the performance of the antigen test was evaluated. Results A total of 1186 patients were included in this study, and the real-time RT-PCR detected SARS-CoV-2 in 105 (8.9%). Of these 105 patients, 33 (31.4%) were asymptomatic. The antigen test provided a 98.8% (95% confidence interval [CI]: 98.0%–99.4%) concordance rate with real-time RT-PCR, along with a sensitivity of 86.7% (95% CI: 78.6%–92.5%) and a specificity of 100% (95% CI: 99.7%–100%). False-negatives were observed in 14 patients, 8 of whom were asymptomatic and had a low viral load (cycle threshold (Ct) > 30). In symptomatic patients, the sensitivity was 91.7% (95% CI: 82.7%–96.9%). Conclusion QuickNavi™-COVID19 Ag showed high specificity and sufficient sensitivity for the detection of SARS-CoV-2. This test is a promising potential diagnostic modality especially in symptomatic patients.
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Affiliation(s)
- Yuto Takeuchi
- Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan; Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan.
| | - Yusaku Akashi
- Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan; Akashi Internal Medicine Clinic, 3-1-63 Asahigaoka, Kashiwara, Osaka, 582-0026, Japan.
| | - Daisuke Kato
- Denka Co., Ltd. Gosen Site, Reaserch & Development Division, Reagent R&D Depertment, 1-2-2 Minami-hon-cho, Gosen-shi, Niigata, 959-1695, Japan.
| | - Miwa Kuwahara
- Denka Co., Ltd. Gosen Site, Reaserch & Development Division, Reagent R&D Depertment, 1-2-2 Minami-hon-cho, Gosen-shi, Niigata, 959-1695, Japan.
| | - Shino Muramatsu
- Denka Co., Ltd. Gosen Site, Reaserch & Development Division, Reagent R&D Depertment, 1-2-2 Minami-hon-cho, Gosen-shi, Niigata, 959-1695, Japan.
| | - Atsuo Ueda
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
| | - Shigeyuki Notake
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
| | - Koji Nakamura
- Department of Clinical Laboratory, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
| | - Hiroichi Ishikawa
- Department of Respiratory Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
| | - Hiromichi Suzuki
- Department of Infectious Diseases, University of Tsukuba Hospital, 2-1-1 Amakubo, Tsukuba, Ibaraki, 305-8576, Japan; Division of Infectious Diseases, Department of Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo Tsukuba, Ibaraki, 305-8558, Japan; Department of Infectious Diseases, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8575, Japan.
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25
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Sato H, Takai C, Kondo N, Kurosawa Y, Hasegawa E, Wakamatsu A, Kobayashi D, Nakatsue T, Abe A, Ito S, Ishikawa H, Kazama JJ, Kuroda T, Suzuki Y, Endo N, Narita I. Cumulative incidence of femoral localized periosteal thickening (beaking) preceding atypical femoral fractures in patients with rheumatoid arthritis. Osteoporos Int 2021; 32:363-375. [PMID: 32885317 DOI: 10.1007/s00198-020-05601-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/12/2020] [Indexed: 11/29/2022]
Abstract
UNLABELLED The incidence of localized periosteal thickening (LPT, also termed beaking) of the lateral cortex that often precedes an atypical femoral fracture (AFF) was not high in patients with rheumatoid arthritis (RA) but incomplete AFFs developed in two patients. Higher-dose prednisolone was a significant risk factor for LPT in patients with RA. INTRODUCTION Atypical femoral fractures (AFFs) are stress fractures; bisphosphonate (BP) use is a major risk factor for the development of such fractures. Localized periosteal thickening (LPT, also termed beaking) of the lateral cortex often precedes a complete or incomplete AFF. We evaluated the incidence of latent LPT in patients with rheumatoid arthritis (RA), to evaluate LPT progression, and to define LPT risk factors. METHODS A total of 254 patients with RA were included; all underwent annual X-ray evaluation, dual-energy X-ray absorptiometry, and analyses of serum and bone metabolic markers for 2-3 years. LPT of the lateral cortex was sought in femoral X-rays. RESULTS The incidence of LPT was 2.4% (6/254). Among patients on both BP and prednisolone (PSL) at enrollment, the incidence was 2.3% (3/131). Two femurs of two patients with LPT developed incomplete AFFs; LPT was extensive and associated with endosteal thickening. One patient had been on BP and PSL and microscopic polyangiitis was comorbidity. The other was on a selective estrogen receptor modulator and PSL. A daily PSL dose >5 mg (OR 11.4; 95%CI 2.15-60.2; p = 0.004) and higher-dose methotrexate (OR 1.22; 95%CI 1.01-1.49; p = 0.043) were significant risk factors for LPT. CONCLUSIONS The incidence of latent LPT was not high (2.4%) but incomplete AFFs developed in two RA patients. Higher-dose PSL because of a comorbid disease requiring glucocorticoid treatment other than RA or refractory RA were risk factors for LPT; X-ray screening for latent LPT would usefully prevent complete AFFs.
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Affiliation(s)
- H Sato
- Department of Rheumatology, Niigata Rheumatic Center, 1-2-8 Honcho, Shibata City, 957-0054, Japan.
- Health Administration Center, Niigata University, 2-8050 Ikarashi, Nishi-ku, Niigata City, 950-2181, Japan.
| | - C Takai
- Department of Rheumatology, Niigata Rheumatic Center, 1-2-8 Honcho, Shibata City, 957-0054, Japan
| | - N Kondo
- Division of Orthopedic Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata City, 951-8510, Japan
| | - Y Kurosawa
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata City, 951-8510, Japan
| | - E Hasegawa
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata City, 951-8510, Japan
| | - A Wakamatsu
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata City, 951-8510, Japan
| | - D Kobayashi
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata City, 951-8510, Japan
| | - T Nakatsue
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata City, 951-8510, Japan
| | - A Abe
- Department of Rheumatology, Niigata Rheumatic Center, 1-2-8 Honcho, Shibata City, 957-0054, Japan
| | - S Ito
- Department of Rheumatology, Niigata Rheumatic Center, 1-2-8 Honcho, Shibata City, 957-0054, Japan
| | - H Ishikawa
- Department of Rheumatology, Niigata Rheumatic Center, 1-2-8 Honcho, Shibata City, 957-0054, Japan
| | - J J Kazama
- Department of Nephrology and Hypertension, Fukushima Medical University, 1 Hikariga-oka, Fukushima City, 960-1295, Japan
| | - T Kuroda
- Health Administration Center, Niigata University, 2-8050 Ikarashi, Nishi-ku, Niigata City, 950-2181, Japan
| | - Y Suzuki
- Health Administration Center, Niigata University, 2-8050 Ikarashi, Nishi-ku, Niigata City, 950-2181, Japan
| | - N Endo
- Division of Orthopedic Surgery, Tsubame Rosai Hospital, 633, Sawatari, Tsubame City, 959-1228, Japan
| | - I Narita
- Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-Dori, Chuo-ku, Niigata City, 951-8510, Japan
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Goto E, Ishikawa H, Okuhara T, Ueno H, Okada H, Fujino Y, Kiuchi T. Presenteeism among workers: health-related factors, work-related factors and health literacy. Occup Med (Lond) 2020; 70:564-569. [PMID: 33180107 DOI: 10.1093/occmed/kqaa168] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Presenteeism is an important factor in workers' health. However, few studies have examined how variables such as socio-economic status, health status, workplace status and health literacy correlate with and affect presenteeism. AIMS To assess the correlates of presenteeism with a focus on health-related factors, work-related factors and health literacy. METHODS We conducted a cross-sectional study of 2914 Japanese workers from one company. We used a self-administered questionnaire to assess socio-demographic characteristics, health status, work environment, presenteeism and health literacy. RESULTS Forty-one per cent of participants were under 40 years of age and 70% were male. We found that 59% of the participants were at high risk of presenteeism. Presenteeism was associated with sex, age, household income, marital status, health-related factors (i.e. self-rated health status, dietary choices, exercise habits), work-related factors (i.e. workplace support, job demands, job control) and health literacy. Logistic regression analyses indicated that presenteeism was associated with self-rated health status, overtime hours, workplace support, job demands, job control and health literacy after adjusting for sex, age and income. CONCLUSIONS Health-related factors, work-related factors and health literacy are all associated with presenteeism. Improving the workplace environment, especially factors such as overtime working hours, workplace support, job demands and job control, and increasing health literacy may reduce presenteeism among general office workers.
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Affiliation(s)
- E Goto
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - H Ishikawa
- Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | - T Okuhara
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - H Ueno
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - H Okada
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Y Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - T Kiuchi
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Iizumi T, Okumura T, Sekino Y, Numajiri H, Mizumoto M, Nakai K, Ishikawa H, Sakurai H. PO-1058: Proton beam therapy for hepatocellular carcinoma of caudate lobe. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01075-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Murofushi K, Tomita T, Ishida T, Baba K, Numajiri H, Mizumoto M, Ohnishi K, Nakai K, Ishikawa H, Okumura T, Sakurai H. The Incidence of Venous Thromboembolism Induced by Prolonged Bed Rest during Interstitial Brachytherapy for Gynecological Cancer. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1530] [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: 11/26/2022]
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Yoshida T, Shibata A, Tanihata A, Hayashi H, Ichikawa Y, Ishikawa H, Yamaguchi Y, Kitada R, Ehara S, Izumiya Y, Yoshiyama M. Thigh intramuscular fat predicts the prognosis in patients in non-ischemic cardiomyopathy with reduced ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Skeletal muscle atrophy is an independent prognostic predictor for patients with chronic heart failure, and the concept of sarcopenia is drawing attention. Furthermore, the importance of not only muscle mass but also intramuscular fat (IMF) has been pointed out. However, there is a lack of consensus on the implications of ectopic fat for the prognosis in patients with non-ischemic cardiomyopathy.
Purpose
We investigated whether ectopic fat in the thigh affects the prognosis with non-ischemic cardiomyopathy.
Methods
We recruited 105 patients who were diagnosed with non-ischemic cardiomyopathy by cardiac catheterization and echocardiographic date between September 2017 and November 2019. Finally 73 patients with reduced EF (EF 40% or less) enrolled in this prospective study. Functional status was evaluated by using cardiopulmonary exercise test at baseline. All patients were measured quantity of epicardial fat and thigh IMF percentage (%IMF) using computed tomography scan. Demographic, laboratory and echocardiographic date were collected from the patients' medical records. Clinical endpoints were unexpected readmission.
Results
During the follow-up period 18 patients had adverse events. The %IMF was significantly higher in the group with adverse events than without (5.57±5.70 and 3.02±2.44%, respectively; p<0.01). Spearman correlation coefficient analysis showed a modest correlation between %IMF and lower limb extension strength (Spearman r=−0.280; p=0.0315), but there was no significant correlation between %IMF and exercise tolerance such as anaerobic threshold and peak oxygen uptake. Patients were divided into 2 groups according to the median values of %IMF. Kaplan-Meier analysis demonstrated that events were significantly higher in the high %IMF group (log-rank p=0.033). Multivariate Cox regression analysis adjusted for left ventricular end-diastolic diameter and peak ventricular oxygen consumption found %IMF as an independent factor of adverse events (hazard ratio 1.545; 95% confidential interval 1.151–2.087; p=0.004).
Conclusions
In non-ischemic cardiomyopathy patients with reduced EF, %IMF may have important adverse consequences such as increased cardiac-related events.
Kaplan-Meier curves
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - A Shibata
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - A Tanihata
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - H Hayashi
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Y Ichikawa
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - H Ishikawa
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Y Yamaguchi
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - R Kitada
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - S Ehara
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Y Izumiya
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Yoshiyama
- Osaka City University Graduate School of Medicine, Osaka, Japan
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Ishikawa H, Izumiya Y, Shibata A, Yoshida T, Hayashi H, Ichikawa Y, Yamaguchi Y, Kitada R, Ehara S, Yoshiyama M. Regional muscle-adipose distribution is different in patients with heart failure with preserved or reduced ejection fraction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Epicardial adipose tissue (EAT) has been recognized to contribute inflammatory activity and atherosclerosis. On the other hand, it has been reported that the volume of EAT is lower in non-ischemic heart failure (HF) patients than healthy individuals. However, the difference in regional muscle-adipose distribution including EAT between HF with preserved ejection fraction (HFpEF) and HF reduced ejection fraction (HFrEF) has not been investigated. In addition, we investigated whether distribution of body composition contributed to exercise capacity.
Methods
The study included 105 non-ischemic HF patients diagnosed by cardiac catheterization between September 2017 and November 2019. Epicardial, abdominal and thigh muscle and adipose tissue volume were measured by computed tomography (CT), and exercise tolerance was evaluated by symptom-limited cardiopulmonary exercise test.
Results
Patients were divided into 2 groups according to the left ventricular ejection fraction, ≥40% as HFpEF (n=28) or <40% as HFrEF (n=77). There was no significant difference comorbidity, including hypertension, dyslipidemia, chronic kidney disease, and body mass index. Plasma B-type natriuretic peptide level was significantly higher in HFrEF than HFpEF group (146.2 vs 393.2 pg/ml, p<0.01), whereas, high-sensitive troponin T level was not different between two groups. Although there was no significant difference in BMI between two groups, the volume of EAT was significantly higher in HFpEF than HFrEF group (81.8 vs 136.4 ml, p=0.01). On the other hand, HFpEF had more thigh adipose tissue compared with HFrEF group (54.6 vs 42.1 ml, p=0.03). There were negative correlations between EAT volume and parameters of exercise capacity such as anaerobic threshold (r=−0.42, p<0.01) and peak VO2 (r=−0.32, p<0.01). Muscle volume itself does not corelate with these parameters.
Conclusion
In patient with nonischemic HF, the pattern of regional adipose distribution may have important role in pathologically. HFpEF and HFrEF has different pattern despite similar body mass index. These differences may be related to impaired exercise tolerance in these 2 different types of HF.
Correlation between EAT and AT, peak VO2
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Ishikawa
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Y Izumiya
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - A Shibata
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - T Yoshida
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - H Hayashi
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Y Ichikawa
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Y Yamaguchi
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - R Kitada
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - S Ehara
- Osaka City University Graduate School of Medicine, Osaka, Japan
| | - M Yoshiyama
- Osaka City University Graduate School of Medicine, Osaka, Japan
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Yamada Y, Tamura T, Yamamoto Y, Ichimura H, Hayashihara K, Saito T, Yamada H, Endo T, Nakamura R, Inage Y, Satoh H, Iguchi K, Saito K, Inagaki M, Kikuchi N, Kurishima K, Ishikawa H, Sakai M, Kamiyama K, Shiozawa T, Hizawa N, Sekine I, Sato Y, Funayama Y, Miyazaki K, Kodama T, Hayashi S, Nomura A, Nakamura H, Furukawa K, Yamashita T, Okubo H, Suzuki H, Kiyoshima M, Kaburagi T. Treatment of Patients With Non-small-cell Lung Cancer With Uncommon EGFR Mutations in Clinical Practice. Anticancer Res 2020; 40:5757-5764. [PMID: 32988903 DOI: 10.21873/anticanres.14592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/06/2020] [Accepted: 07/10/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM To describe real clinical outcomes in patients with non-small cell lung cancer who have uncommon epidermal growth factor receptor (EGFR) mutations. MATERIALS AND METHODS We performed a retrospective chart review from 15 medical institutes that cover a population of three million people from April 2008 to March 2019. RESULTS There were 102 patients with uncommon EGFR mutation. Progression-free survival (PFS) tended to be longer in patients receiving afatinib compared with first-generation EGFR tyrosine kinase inhibitors. PFS in patients treated with afatinib or osimertinib was significantly longer than in patients treated with gefitinib or erlotinib (p=0.030). Multivariate analysis also revealed the contribution of afatinib or osimertinib to increased survival. In patients with exon 20 insertions, chemotherapy was efficacious. CONCLUSION In treating patients with uncommon EGFR mutations, our results indicate longer-term survival might be achieved with second-generation or later TKIs and cytotoxic chemotherapeutic drugs.
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Affiliation(s)
- Yutaka Yamada
- Respiratory Center, Ibaraki Prefectural Central Hospital and Cancer Center, Kasama, Japan
| | - Tomohiro Tamura
- Respiratory Center, Ibaraki Prefectural Central Hospital and Cancer Center, Kasama, Japan
| | - Yusuke Yamamoto
- Divisions of Respiratory Medicine and Thoracic Surgery, Hitachi General Hospital, Hitachi, Japan
| | - Hideo Ichimura
- Divisions of Respiratory Medicine and Thoracic Surgery, Hitachi General Hospital, Hitachi, Japan
| | - Kenji Hayashihara
- Division of Respiratory Medicine, Ibarakihigashi Hospital, Tokai, Japan
| | - Takefumi Saito
- Division of Respiratory Medicine, Ibarakihigashi Hospital, Tokai, Japan
| | - Hideyasu Yamada
- Division of Respiratory Medicine, Hitachinaka General Hospital-Hitachinaka Medical Center, University of Tsukuba, Hitachinaka, Japan
| | - Takeo Endo
- Divisions of Respiratory Medicine and Thoracic Surgery, Mito Medical Center, Mito, Japan
| | - Ryota Nakamura
- Divisions of Respiratory Medicine and Thoracic Surgery, Mito Medical Center, Mito, Japan
| | - Yoshihisa Inage
- Divisions of Respiratory Medicine and Thoracic Surgery, Mito Medical Center, Mito, Japan
| | - Hiroaki Satoh
- Divisions of Respiratory Medicine and Thoracic Surgery, Mito Kyodo General Hospital-Mito Medical Center, University of Tsukuba, Mito, Japan
| | - Kesato Iguchi
- Divisions of Respiratory Medicine and Thoracic Surgery, Mito Kyodo General Hospital-Mito Medical Center, University of Tsukuba, Mito, Japan
| | - Kazuto Saito
- Divisions of Respiratory Medicine and Thoracic Surgery, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Masaharu Inagaki
- Divisions of Respiratory Medicine and Thoracic Surgery, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Norihiro Kikuchi
- Division of Respiratory Medicine, Kasumigaura Medical Center Hospital, Tsuchiura, Japan
| | - Koichi Kurishima
- Divisions of Respiratory Medicine and Thoracic Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Hiroichi Ishikawa
- Divisions of Respiratory Medicine and Thoracic Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Mitsuaki Sakai
- Divisions of Respiratory Medicine and Thoracic Surgery, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Koichi Kamiyama
- Division of Respiratory Medicine, Tsukuba Memorial Hospital, Tsukuba, Japan
| | | | - Nobuyuki Hizawa
- Faculty of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Ikuo Sekine
- Faculty of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yukio Sato
- Faculty of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yasunori Funayama
- Division of Respiratory Medicine, Tsukuba Gakuen Hospital, Tsukuba, Japan
| | - Kunihiko Miyazaki
- Division of Respiratory Medicine, Ryugasaki Saiseikai Hospital, Ryugasaki, Japan
| | - Takahide Kodama
- Division of Respiratory Medicine, Ryugasaki Saiseikai Hospital, Ryugasaki, Japan
| | - Shigen Hayashi
- Division of Respiratory Medicine, Ibaraki Seinan Medical Center Hospital, Sakai, Japan
| | - Akihiro Nomura
- Division of Respiratory Medicine, Ibaraki Seinan Medical Center Hospital, Sakai, Japan
| | - Hiroyuki Nakamura
- Division of Respiratory Medicine, Tokyo Medical University, Ibaraki Medical Center, Ami, Japan
| | - Kinya Furukawa
- Division of Respiratory Medicine, Tokyo Medical University, Ibaraki Medical Center, Ami, Japan
| | - Takaaki Yamashita
- Division of Respiratory Medicine, JA Toride Medical Center Hospital, Toride, Japan
| | - Hatsumi Okubo
- Respiratory Center, Ibaraki Prefectural Central Hospital and Cancer Center, Kasama, Japan
| | - Hisashi Suzuki
- Respiratory Center, Ibaraki Prefectural Central Hospital and Cancer Center, Kasama, Japan
| | - Moriyuki Kiyoshima
- Respiratory Center, Ibaraki Prefectural Central Hospital and Cancer Center, Kasama, Japan
| | - Takayuki Kaburagi
- Respiratory Center, Ibaraki Prefectural Central Hospital and Cancer Center, Kasama, Japan
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Heinsalu S, Isogai Y, Matsushima Y, Ishikawa H, Utaka K. Record-high sensitivity compact multi-slot sub-wavelength Bragg grating refractive index sensor on SOI platform. Opt Express 2020; 28:28126-28139. [PMID: 32988090 DOI: 10.1364/oe.402672] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 08/28/2020] [Indexed: 06/11/2023]
Abstract
In this paper, a high sensitivity compact multi-slot sub-wavelength Bragg grating refractive index (RI) sensor was investigated. The structural parameters were optimized for higher sensitivity to RI change of the surrounding medium from viewpoints of a wavelength shift, an extinction ratio and a transmission loss, and a record-high sensitivity was experimentally demonstrated with a compact size. In this sensor, the first side-lobe at the Bragg grating (BG) stop-band end was focused as a sensing peak wavelength for moderate transmission loss and efficient sensing. To realize the compactness, a period count of the BG was kept as small as 20. By increasing the RI of the surrounding medium, the sensing peak shifts toward a longer wavelength side; thus due to the high sharpness and easy tracing of the first side-lobe, the device worked as an efficient RI sensor. The structural optimization was carried out by using 3D finite-difference time-domain (FDTD) simulation approach, and also influences of the structural parameters to sensitivities were discussed. Based on these optimized parameters, the devices were fabricated using the lift-off technique. By exposing the sensor to various liquid samples with different RIs such as pure water, sugar-dissolved water with various concentrations, acetone and isopropyl alcohol (IPA), a record-high sensitivity of 730 nm/RIU was attained for a sensor fabricated on SOI platforms with a length of as small as 9.5 µm and a transmission loss of 3 dB.
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Yamada S, Fujii T, Yamamoto T, Takami H, Yoshioka I, Yamaki S, Sonohara F, Shibuya K, Motoi F, Hirano S, Murakami Y, Inoue H, Hayashi M, Murotani K, Kitayama J, Ishikawa H, Kodera Y, Sekimoto M, Satoi S. Phase I/II study of adding intraperitoneal paclitaxel in patients with pancreatic cancer and peritoneal metastasis. Br J Surg 2020; 107:1811-1817. [PMID: 32638367 PMCID: PMC7689756 DOI: 10.1002/bjs.11792] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [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: 02/23/2020] [Revised: 04/27/2020] [Accepted: 05/19/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Intraperitoneal chemotherapy using paclitaxel is considered an experimental approach for treating peritoneal carcinomatosis. This study aimed to determine the recommended dose, and to evaluate the clinical efficacy and safety, of the combination of intravenous gemcitabine, intravenous nab-paclitaxel and intraperitoneal paclitaxel in patients with pancreatic cancer and peritoneal metastasis. METHODS The frequencies of dose-limiting toxicities were evaluated, and the recommended dose was determined in phase I. The primary endpoint of the phase II analysis was overall survival rate at 1 year. Secondary endpoints were antitumour effects, symptom-relieving effects, safety and overall survival. RESULTS The recommended doses of intravenous gemcitabine, intravenous nab-paclitaxel and intraperitoneal paclitaxel were 800, 75 and 20 mg/m2 respectively. Among 46 patients enrolled in phase II, the median time to treatment failure was 6·0 (range 0-22·6) months. The response and disease control rates were 21 of 43 and 41 of 43 respectively. Ascites disappeared in 12 of 30 patients, and cytology became negative in 18 of 46. The median survival time was 14·5 months, and the 1-year overall survival rate was 61 per cent. Conversion surgery was performed in eight of 46 patients, and those who underwent resection survived significantly longer than those who were not treated surgically (median survival not reached versus 12·4 months). Grade 3-4 haematological toxicities developed in 35 of 46 patients, whereas non-haematological adverse events occurred in seven patients. CONCLUSION Adding intraperitoneal paclitaxel had clinical efficacy with acceptable tolerability.
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Affiliation(s)
- S Yamada
- Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - T Fujii
- Department of Surgery and Science Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - T Yamamoto
- Department of Surgery, Kansai Medical University, Hirakata, Japan
| | - H Takami
- Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - I Yoshioka
- Department of Surgery and Science Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - S Yamaki
- Department of Surgery, Kansai Medical University, Hirakata, Japan
| | - F Sonohara
- Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - K Shibuya
- Department of Surgery and Science Faculty of Medicine, Academic Assembly, University of Toyama, Toyama, Japan
| | - F Motoi
- Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - S Hirano
- Department of Surgery, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - Y Murakami
- Department of Gastroenterological Surgery II, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - H Inoue
- Department of Hepatobiliary-pancreatic and Breast Surgery, Ehime University Graduate School of Medicine, Ehime, Fukuoka, Japan
| | - M Hayashi
- Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - K Murotani
- Biostatistics Centre, Graduate School of Medicine, Kurume University, Fukuoka, Japan
| | - J Kitayama
- Department of Gastrointestinal Surgery, Jichi Medical University, Tochigi, Japan
| | - H Ishikawa
- Department of Molecular-Targeting Cancer Prevention, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Y Kodera
- Gastroenterological Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - M Sekimoto
- Department of Surgery, Kansai Medical University, Hirakata, Japan
| | - S Satoi
- Department of Surgery, Kansai Medical University, Hirakata, Japan
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Miyazaki K, Sato S, Kodama T, Numata T, Endo T, Yamamoto Y, Shimizu K, Yamada H, Hayashihara K, Okauchi S, Satoh H, Yamada Y, Tamura T, Saito K, Kikuchi N, Kurishima K, Ishikawa H, Watanabe H, Shiozawa T, Hizawa N, Funayama Y, Hayashi S, Nakamura H, Yamashita T. Clinicopathological Features in Elderly ALK-rearranged Non-small Cell Lung Cancer Patients. In Vivo 2020; 34:2001-2007. [PMID: 32606173 DOI: 10.21873/invivo.11998] [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: 03/21/2020] [Revised: 04/02/2020] [Accepted: 04/06/2020] [Indexed: 11/10/2022]
Abstract
AIM To clarify the clinicopathological features in elderly anaplastic lymphoma kinase (ALK) rearranged non-small cell lung cancer (NSCLC) patients. PATIENTS AND METHODS A retrospective study was performed in 129 ALK rearranged NSCLC patients diagnosed between April 2008 and March 2019 in fifteen Institutions of the Ibaraki prefecture, Japan. RESULTS Median age of patients was 63 years. In 59 patients aged 65 and older, the proportions of patients with advanced stage and those treated with ALK-tyrosine kinase inhibitor (TKI) were lower than those younger than 65 years. There was no difference in overall survival (OS) between the two age groups. Among the elderly patients, no difference was observed in OS between the patients aged 65-69 and those aged 70 and older. In 89 patients treated with TKI, no significant differences were observed in the progression-free survival of TKIs and OS between patients aged 65 and older and those younger than 65, respectively. CONCLUSION Evaluation of ALK gene status and TKI treatment are desirable even for elderly patients.
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Affiliation(s)
- Kunihiko Miyazaki
- Division of Respiratory Medicine, Ryugasaki Saiseikai Hospital, Ryugasaki, Japan
| | - Shinya Sato
- Division of Respiratory Medicine, Ryugasaki Saiseikai Hospital, Ryugasaki, Japan
| | - Takahide Kodama
- Division of Respiratory Medicine, Ryugasaki Saiseikai Hospital, Ryugasaki, Japan
| | - Takeshi Numata
- Division of Respiratory Medicine, Mito Medical Center, Mito, Japan
| | - Takeo Endo
- Division of Respiratory Medicine, Mito Medical Center, Mito, Japan
| | - Yusuke Yamamoto
- Division of Respiratory Medicine, Hitachi General Hospital, Hitachi, Japan
| | - Kei Shimizu
- Division of Respiratory Medicine, Hitachi General Hospital, Hitachi, Japan
| | - Hideyasu Yamada
- Division of Respiratory Medicine, Hitachinaka General Hospital-Hitachinaka Medical Center, University of Tsukuba, Hitachinaka, Japan
| | - Kenji Hayashihara
- Division of Respiratory Medicine, Ibarakihigashi Hospital, Tokai, Japan
| | - Shinichiro Okauchi
- Divisions of Respiratory Medicine and Thoracic Surgery, Mito Kyodo General Hospital-Mito Medical Center, University of Tsukuba, Mito, Japan
| | - Hiroaki Satoh
- Divisions of Respiratory Medicine and Thoracic Surgery, Mito Kyodo General Hospital-Mito Medical Center, University of Tsukuba, Mito, Japan
| | - Yutaka Yamada
- Respiratory Center, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Tomohiro Tamura
- Respiratory Center, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Kazuto Saito
- Division of Thoracic Surgery, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Norihiro Kikuchi
- Division of Respiratory Medicine, Kasumigaura Medical Center Hospital, Tsuchiura, Japan
| | - Koichi Kurishima
- Division of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Hiroichi Ishikawa
- Division of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Hiroko Watanabe
- Division of Respiratory Medicine, Tsukuba Kinen Hospital, Tsukuba, Japan
| | | | - Nobuyuki Hizawa
- Faculty of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yasunori Funayama
- Division of Respiratory Medicine Tsukuba, Gakuen General Hospital, Tsukuba, Japan
| | - Shigen Hayashi
- Division of Respiratory Medicine, Ibaraki Seinan Medical Center Hospital, Sakai, Japan
| | - Hiroyuki Nakamura
- Division of Respiratory Medicine, Tokyo Medical University, Ibaraki Medical Center, Ami-machi, Japan
| | - Takaaki Yamashita
- Division of Respiratory Medicine, JA Toride Medical Center Hospital, Toride, Japan
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Numata T, Endo T, Yanai H, Ota K, Yamamoto Y, Shimizu K, Yamada H, Hayashihara K, Okauchi S, Satoh H, Yamada Y, Tamura T, Saito K, Kikuchi N, Kurishima K, Ishikawa H, Watanabe H, Shiozawa T, Hizawa N, Funayama Y, Hayashi S, Nakamura H, Yamashita T. Serum CEA and CYFRA Levels in ALK-rearranged NSCLC Patients: Correlation With Distant Metastasis. In Vivo 2020; 34:2095-2100. [PMID: 32606188 DOI: 10.21873/invivo.12013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 03/31/2020] [Accepted: 04/01/2020] [Indexed: 12/11/2022]
Abstract
AIM To clarify the correlation between serum levels of carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA) and metastasis and survival in anaplastic lymphoma kinase (ALK)-rearranged non-small cell lung cancer (NSCLC) patients. PATIENTS AND METHODS CEA and CYFRA levels in 131 ALK-rearranged NSCLC patients were determined using fluorescence in situ hybridization (FISH), real time-reverse transcription polymerase chain reaction, and immunohistochemistry, using biopsy specimens, cytology specimens, and plasma specimens. Cut-off value of each marker was determined as 10 ng/ml. RESULTS In logistic regression analysis, higher levels of both markers had a positive relationship with bone metastases, and higher levels of CYFRA was relevant to liver metastases, and multiple-organ metastases. However, these markers were not proven to be poor prognostic factors in Cox's proportional model analysis. CONCLUSION Elevated serum CEA and CYFRA levels seem to provide useful clinical information about presence of bone and liver metastasis and multiple-organ metastases, although they were not a powerful indicator of prognosis. These two markers may suggest the extension of metastasis and would be helpful in considering treatment options.
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Affiliation(s)
- Takeshi Numata
- Division of Respiratory Medicine, Mito Medical Center, Ibaraki-machi, Japan
| | - Takeo Endo
- Division of Respiratory Medicine, Mito Medical Center, Ibaraki-machi, Japan
| | - Hidetoshi Yanai
- Division of Respiratory Medicine, Mito Medical Center, Ibaraki-machi, Japan
| | - Kyoko Ota
- Division of Respiratory Medicine, Mito Medical Center, Ibaraki-machi, Japan
| | - Yusuke Yamamoto
- Division of Respiratory Medicine, Hitachi General Hospital, Hitachi, Japan
| | - Kei Shimizu
- Division of Respiratory Medicine, Hitachi General Hospital, Hitachi, Japan
| | - Hideyasu Yamada
- Division of Respiratory Medicine, Hitachinaka Medical Center-Hitachinaka Medical Center, University of Tsukuba, Hitachinaka, Japan
| | - Kenji Hayashihara
- Division of Respiratory Medicine, Ibarakihigashi Hospital, Tokai, Japan
| | - Shinichiro Okauchi
- Division of Respiratory Medicine, Mito Kyodo General Hospital-Mito Medical Center, University of Tsukuba, Mito, Japan
| | - Hiroaki Satoh
- Division of Respiratory Medicine, Mito Kyodo General Hospital-Mito Medical Center, University of Tsukuba, Mito, Japan
| | - Yutaka Yamada
- Respiratory Center, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Tomohiro Tamura
- Respiratory Center, Ibaraki Prefectural Central Hospital, Kasama, Japan
| | - Kazuto Saito
- Division of Respiratory Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Norihiro Kikuchi
- Division of Respiratory Medicine, Kasumigaura Medical Center Hospital, Tsuchiura, Japan
| | - Koichi Kurishima
- Division of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Hiroichi Ishikawa
- Division of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Hiroko Watanabe
- Division of Thoracic Surgery, Tsukuba Kinen Hospital, Tsukuba, Japan
| | | | - Nobuyuki Hizawa
- Faculty of Clinical Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yasunori Funayama
- Division of Respiratory Medicine, Tsukuba Gakuen General Hospital, Tsukuba, Japan
| | - Shigen Hayashi
- Division of Respiratory Medicine, Ibaraki Seinan Medical Center Hospital, Sakai-machi, Japan
| | - Hiroyuki Nakamura
- Division of Respiratory Medicine, Tokyo Medical University, Ibaraki Medical Center, Ami-machi, Japan
| | - Takaaki Yamashita
- Division of Respiratory Medicine, JA Toride Medical Center Hospital, Toride, Japan
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Kojima T, Kojima M, Ishikawa H, Nishida K, Asai S, Ishiguro N. AB1172 IMPROVEMENT OF DEPRESSION BY JOINT SURGERY IN ESTABLISHED RHEUMATOID ARTHRITIS; RESULTS FROM MULTICENTER PROSPECTIVE COHORT STUDY FOR EVALUATION OF JOINT SURGERY ON PATIENT’S REPORTED OUTCOME. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.4218] [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:Total management including reconstructive joint surgery and rehabilitation should be needed for further improvements of physical function for long-standing RA patients. In these days, it is very important to evaluate the effectiveness of joint surgery as well as drug therapy based on patient-reported outcome (PRO)Objectives:The purpose of this study is to explore the relationship among depression, clinical variables and other PROs including physical function and to explore whether joint surgery can improve the depression.Methods:Multicenter prospective observational cohort study was conducted among patients who underwent elective joint surgery for RA from April 2012 to March 2016 (Study registration: UMIN000012649). In this study, we collected data at baseline and at 6 or 12 months after the surgery. These data were as follow; age, sex, disease duration, drug therapies, and disease activity (DAS), TUG, and patient-reported outcome [HAQ-DI, EQ-5D (QOL), pain and BDI-II (depression)]. Correlation between BDI-II and other variables were determined using multiple liner regression analysis.Results:Totally, 346 patients before elective joint surgery were analyzed cross-sectionally. Mean age, disease duration, pain VAS, DAS28, HAQ-DI, EQ-5D and BDI-II were 64.2 years, 17.0 years, 36.2 mm, 3.02, 1.11, 0.641 and 13.0, respectively. 52.6% of elective joint surgeries were in upper limbs and 47.4% were in lower limbs. Multiple liner regression analysis showed that HAQ-DI [B:-0.099 (95%CI:-0.117- -0.08) β:-0.48] pain VAS [B:-0.002 (95%CI:-0.002- -0.001) β:-0.26] and BDI-II [B:-0.003 (95%CI:-0.005- -0.002) β:-0.19] had significant impact on EQ-5D. Furthermore, HAQ-DI [B:3.78 (95%CI:2.54- 5.06) β: 0.33] and pain VAS [B: 0.062 (95%CI: 0.023- 0.101) β 0.17] had significant impact on BDI-II. Especially, walking and eating were independent factors for BDI-II in HAQ-DI categories. These results were confirmed in longitudinal analyses using results from joint surgery in lower limbs (LL; n=138) and upper limbs (UL; n=165), respectively. BDI-II was remarkably improved from 12.1 (mean) to 10.5 in LL and from 14.2 (mean) to 11.9 in UL. Change in HAQ-DI had significant impact on that in BDI-II [LL; B:3.183 (95%CI:0.301- 6.065) β:0.229, and UL; B:2.55 (95%CI:0.19- 4.92) β:0.19] while that in painVAS did not. Especially, the improving in walking category by LL [B:1.38 (95%CI:0.06- 2.70) β:0.18] and in hygiene category by UL [B:2.11 (95%CI:0.79- 3.42) β:0.24] were relevant factors for improving of BDI-II.Conclusion:Depression is an important patient-reported outcome for QOL in established RA patients. Improving of physical function with joint surgery in both lower and upper limbs caused improving of depression status. Rheumatologists should take the joint surgery into consideration as effective intervention for treatment of established RA patients with treatment.Acknowledgments:This study was funded by a grant from the Ministry of Health, Labour and Walfare (h2424YN002-00) to Naoki Ishiguro.We thank Drs Tanaka S, Haga N, Yukioka M, Hashimoto J, Miyahara H, Niki Y, Kimura T, Oda H, Funahashi K for their contribution to this study and all medical staff members of each institute for their data collection efforts for their data collection efforts.Disclosure of Interests:Toshihisa Kojima Grant/research support from: Chugai, Eli Lilly, Astellas, Abbvie, and Novartis, Consultant of: AbbVie, Speakers bureau: AbbVie, Astellas, Bristol-Myers Squibb, Chugai, Daiichi-Sankyo, Eli Lilly, Janssen, Mitsubishi Tanabe, Pfizer, and Takeda, Masayo Kojima: None declared, Hajime Ishikawa: None declared, Keiichiro Nishida Grant/research support from: K. Nishida has received scholarship donation from CHUGAI PHARMACEUTICAL Co., Eisai Co., Mitsubishi Tanabe Pharma and AbbVie GK., Speakers bureau: K. Nishida has received speaking fees from CHUGAI PHARMACEUTICAL Co., Eli Lilly, Janssen Pharmaceutical K.K., Eisai Co. and AYUMI Pharmaceutical Corporation., Shuji Asai Speakers bureau: AbbVie, Astellas, Bristol-Myers Squibb, Chugai, Daiichi-Sankyo, Eisai, Janssen, Takeda, and UCB Japan, Naoki Ishiguro Grant/research support from: AbbVie, Asahi Kasei, Astellas, Chugai, Daiichi-Sankyo, Eisai, Kaken, Mitsubishi Tanabe, Otsuka, Pfizer, Takeda, and Zimmer Biomet, Consultant of: Ono, Speakers bureau: Astellas, Bristol-Myers Squibb, Daiichi-Sankyo, Eli Lilly, Pfizer, and Taisho Toyama
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Okita S, Ishikawa H, Abe A, Ito S, Murasawa A, Nishida K, Ozaki T. SAT0047 RISK FACTORS FOR THE POSTOPERATIVE DELAYED WOUND HEALING IN PATIENTS WITH RHEUMATOID ARTHRITIS TREATED WITH A BIOLOGICAL AGENT. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.3424] [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
Background:It has been suggested that perioperative use of biological disease-modifying anti-rheumatic drugs (bDMARDs) in rheumatoid arthritis (RA) patients carries risks for the surgical-site infection and the delayed wound healing (DWH); however, the risk of DWH with perioperative use of bDMARDs has not reached a general consensus.Objectives:This retrospective study aimed to investigate the risk factors associated with DWH after orthopedic surgery in RA patients treated with bDMARDs.Methods:We reviewed medical records of 277 orthopedic procedures for 188 RA patients treated with bDMARDs between from 2014 to 2017 in Niigata Rheumatic Center. As preoperative nutritional status assessment, we evaluated body mass index (BMI), prognostic nutritional index (PNI), and CONtrolling NUTritional status (CONUT). In addition, we evaluated DAS28-CRP, DAS28-ESR, face scale for pain, global health (GH), and Health Assessment Questionnaire-Disability Index (HAQ-DI) to assess the disease activity. Univariate and multivariate logistic regression analyses were performed to evaluate the risk factor for DWH.Results:The major characteristics of the patients in 277 procedures were mean age of 63.2 years old and mean disease duration of 18.2 years. Surgical site were hand and wrist (145 procedures), foot and ankle (76), hip and knee (31), elbow and shoulder (24), and spine (1). Seventy-four patients were treated with tocilizumab, 62 with etanercept, 55 with golimumab, 49 with abatacept, 16 with infliximab, 15 with adalimumab, and 6 with certolizumab. According to nutritional assessment in PNI and CONUT, 63% (n=175) and 47% (n=130) were normal nourished patients, respectively.In 277 procedures, DWH were identified in 24 patients (8.6%). The following variables were significant in the univariate analyses: disease duration (OR 1.053; 95% CI 1.010–1.099; p=0.016), foot and ankle surgery (OR 7.091; 95% CI 2.130–23.603; p=0.001), tocilizumab (OR 0.286; 95% CI 0.093–0.881; p=0.029) (Table 1). These variables were entered into a multivariate model, and it was revealed that pre-operative use of tocilizumab (OR 0.265; 95% CI 0.074–0.953; p=0.042) and procedures in the foot and ankle (OR 6.915; 95% CI 1.914–24.976; p=0.003) were associated with an increased risk of DWH (Table 1).Conclusion:As previous study on tocilizumab described, the current retrospective study suggested that pre-operative use of tocilizumab and procedures in the foot and ankle were risk factors for DWH. Pre-operative disease activity and nutritional status were not independent risk factors for an increase in the prevalence of DWH.References:[1] Momohara S, Hashimoto J, Tsuboi H et al. Analysis of perioperative clinical features and complications after orthopaedic surgery in rheumatoid arthritis patients treated with tocilizumab in a real-world setting: Results from the multicentre tocilizumab in perioperative period (TOPP) study. Modern rheumatology. 2013, 23: 440-9.Disclosure of Interests:Shunji Okita: None declared, Hajime Ishikawa: None declared, Asami Abe: None declared, Satoshi Ito Speakers bureau: Abbvie,Eisai, Akira Murasawa: None declared, Keiichiro Nishida Grant/research support from: K. Nishida has received scholarship donation from CHUGAI PHARMACEUTICAL Co., Eisai Co., Mitsubishi Tanabe Pharma and AbbVie GK., Speakers bureau: K. Nishida has received speaking fees from CHUGAI PHARMACEUTICAL Co., Eli Lilly, Janssen Pharmaceutical K.K., Eisai Co. and AYUMI Pharmaceutical Corporation., Toshifumi Ozaki: None declared
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Ito S, Sakai S, Kurosawa Y, Kobayashi D, Okabayashi R, Abe A, Otani H, Nakazono K, Murasawa A, Narita I, Ishikawa H. AB0297 THE LONG-TERM OBSERVATION OF PATIENTS WITH RHEUMATOID ARTHRITIS WHO ACHIEVED A BIO-FREE CONDITION WITH ADALIMUMAB. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2406] [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:Biological disease-modifying antirheumatic drugs (bDMARDs) caused a paradigm shift in the treatment of rheumatoid arthritis (RA). However, their high cost is a burden for patients and the national medical economy.Objectives:To analyze the long-term outcomes of patients with RA who achieved a bio-free condition (BF) with adalimumab (ADA).Methods:We followed 25 patients (male 6, female 19) who discontinued ADA with clinical remission (CR), and one female with a low disease activity (LDA), over 19.4 ±7.8 months of ADA treatment1). At the introduction of ADA, the average age was 51.2 ± 11.9 years old, and the average disease duration was 45.1 ± 48.4 months. The disease activity measured by disease activity score based on C-reactive protein (DAS28-CRP) was defined as follows: CR, <2.3; LDA, 2.3 - 2.7; moderate DA, 2.7 -4.1; and high DA, > 4.1, since the DAS28-CRP tends to be lower than the DAS28-based on the erythrocyte sedimentation rate in Japanese patients2).Results:We lost one patient with a transfer to another hospital. Four patients re-started ADA due to flare (DAS28-CRP>2.7) but achieved CR (in BF) again with the intensification of the treatment (dose increase or initiation of prednisolone [PSL] and/or conventional synthetic [cs] DMARDs such as tacrolimus or iguratimode). The DAS28-CRP significantly decreased from 3.45 ± 1.32 at base line (BL) to 1.55 ± 0.41 (p<0.0001) at BF. It remained 1.59 ± 0.59 (n=25) at 24 months after BF, 1.56 ± 0.39 (n= 20) at 48 months, 1.8 ± 0.7 (n=11) at 60 months. At the last observation, every patient remained in CR up to 84 months (n=2, Figure 1). The modified health assessment questionnaire score significantly decreased from 0.42 ± 0.46 (BL, n=19) to 0.02 ± 0.05 (p<0.002) at BF. It remained 0.03 ± 0.07 (n=19) at 24 months and 0.06 ± 0.14 (n=14) at 48 months, 0.04 ± 0.08 at 60 months (n=9). The PSL dose (mg/day) decreased from 3.2 ± 3.3 (BL) to 2.2 ± 2.8 at BF and 2.04 ± 2.13 (n=25) at 24 months, 1.73 ± 1.9 (n=20) at 48 months, and 1.6 ± 2.3 (n=11) at 60 months, but there were no significant changes. The methotrexate (MTX) dose (mg/week) increased from 10.1 ± 2.9 (BL) to 10.6 ± 2.6 (p< 0.78) at BF, 10.4 ± 3.3 (n=25) at 24 months, 10.7 ± 3.4 (n=20) at 48 months, 10.4 ± 3.1 at 60 months (not significant). The number of csDMARDs significantly increased from 0.8 ± 0.6 (BL) to 1.3 ± 0.9 (p<0.001, at BF), 2.56 ± 0.94 (n=25) at 24 months, 1.6 ± 1.01 (n=20) at 48 mnths, and 1.6 ± 2.3 at 60 months (n=11, Figure 2).Conclusion:BF can be sustained with an adequate dose of MTX and combination of csDMARDs.References:[1]Ito S, et al. An analysis of the biological disease-modifying antirheumatic drug-free condition of adalimumab-treated rheumatoid arthritis patients. Intern Med 58: 511-519, 2019[2]Inoue E, et al. Comparison of Disease Activity Score (DAS)28-erythrocyte sedimentation rate and DAS28- C-reactive protein threshold values. Ann Rheum Dis. 66:407-409, 2007.Disclosure of Interests:Satoshi Ito Speakers bureau: Abbvie,Eisai, Shunsuke sakai: None declared, Yoichi Kurosawa: None declared, Daisuke Kobayashi: None declared, Ryo Okabayashi: None declared, Asami Abe: None declared, Hiroshi Otani: None declared, Kiyoshi Nakazono: None declared, Akira Murasawa: None declared, Ichiei Narita: None declared, Hajime Ishikawa: None declared
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Kobayashi D, Hasegawa E, Wada Y, Ito S, Abe A, Nakazono K, Murasawa A, Narita I, Ishikawa H. SAT0147 EFFICACY AND SAFETY OF IGURATIMOD AS FIRST-LINE DISEASE-MODIFYING ANTIRHEUMATIC DRUG THERAPY FOR PATIENTS WITH RHEUMATOID ARTHRITIS. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.2691] [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:Although methotrexate is the anchor drug, it took some days to check contraindications, such as interstitial pneumonia, hepatitis B virus infection, and latent tuberculosis infection. Therefore, we sometimes start rheumatoid arthritis (RA) treatment with other disease-modifying antirheumatic drug (DMARD) in daily clinical setting. Iguratimod (IGU) is a newly developed DMARD approved in Japan in September 2012, and the efficacy of IGU for DMARD naïve patients has not been thoroughly evaluated.Objectives:The aim of this prospective single-center study was to demonstrate the efficacy and safety of IGU when used as a first-line daily DMARD for patients with RA in a clinical setting.Methods:Enrolled patients included those diagnosed with RA according to the 2010 American College of Rheumatology/European League against Rheumatism (ACR/EULAR) classification criteria who took IGU as a first-line DMARD at Niigata Rheumatic Center between April 2016 and December 2018 (IGU group). There were no constraints regarding the addition or withdrawal of other DMARDs. Details of the patients’ background, clinical parameters, and laboratory findings were obtained, including C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), matrix metalloprotease-3 (MMP-3), rheumatoid factor (RF), Disease Activity Score for 28-joint counts based on the erythrocyte sedimentation rate (DAS28-4[ESR]), Clinical Disease Activity Index (CDAI), and Health Assessment Questionnaire Disability Index (HAQ-DI). The efficacy of IGU was evaluated at week 24. The IGU group’s data were then compared with 64 patients who took salazosulfapyridine or bucillamine as first-line DMARD in our hospital (other DMARD group). The data were expressed as median values. Comparisons between the parameters were performed using nonparametric method.Results:Forty-three patients (15 males, 28 females) received IGU as a first-line DMARD for RA. The age was 69.0 years and the duration of disease was 2.0 months. Twenty patients received prednisolone (PSL) concomitantly at a median dose of 5.0 mg/day. At 24 weeks medications were utilized in patients as follows: IGU in 36 (83.7 %), methotrexate in 18 (41.2%), PSL in 17 (39.5%), BUC in 10 (23.2 %), and biological DMARD in 7 (15.2 %) patients. Although 7 patients discontinued taking IGU due to liver enzyme elevation (n=4), nausea (n=1), creatinine elevation (n=1), and skin rash (n=1) during the 24-week period, serious adverse events requiring hospitalization were not observed. Clinical parameters that improved from baseline after 24 weeks of treatment included: ESR from 42.0 mm/h to 16.0 mm/h with p < 0.001; CRP from 0.70 mg/dL to 0.10 mg/dL with p< 0.001; MMP-3 from 136 ng/mL to 91.5 ng/mL with a p value of 0.11; RF went from 18.0 IU/mL to 8.00 IU/mL with p < 0.001; DAS28(4)-ESR dropped from 5.13 to 2.73 with p< 0.001; CDAI dropped from 20.0 to 5.00 with p< 0.001, and HAQ-DI decreased from 0.55 to 0.00 with p< 0.001. Patients who achieved a good or moderate response based on EULAR response at 24 weeks, included 90.7% in the IGU group versus 70.5% in the other DMARD group (Fisher`s exact test, p=0.046). The retention rate of the IGU group was 81.4 %, roughly equivalent to the 81.2% retention rate in the other DMARD group (Log-rank test, p=0.733).Conclusion:Our study indicates IGU is safe and effective for DMARD naïve RA patients. Starting treatment with IGU might be a new and effective strategy for RA patients without previous use of a DMARD.Disclosure of Interests:Daisuke Kobayashi: None declared, Eriko Hasegawa: None declared, Yoko Wada: None declared, Satoshi Ito Speakers bureau: Abbvie,Eisai, Asami Abe: None declared, Kiyoshi Nakazono: None declared, Akira Murasawa: None declared, Ichiei Narita: None declared, Hajime Ishikawa: None declared
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Kiyasu Y, Hitomi S, Funayama Y, Saito K, Ishikawa H. Characteristics of invasive Acinetobacter infection: A multicenter investigation with molecular identification of causative organisms. J Infect Chemother 2020; 26:475-482. [PMID: 31924521 DOI: 10.1016/j.jiac.2019.12.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 12/02/2019] [Accepted: 12/06/2019] [Indexed: 11/24/2022]
Abstract
We examined microbiological and clinical characteristics of invasive Acinetobacter infection occurring in four hospitals located in the Minami-Ibaraki Area. Glucose-non-fermentative Gram-negative bacilli isolated from the blood and the cerebrospinal fluid in independent cases between 2001 and 2014 were consecutively collected and those possibly to be Acinetobacter species were re-identified using molecular methods. Of 158 strains identified as Acinetobacter species, 155 were classified into 16 officially designated species, including 42 Acinetobacter pittii and 40 Acinetobacter baumannii. Imipenem non-susceptibility was detected only in 4 strains, none of which demonstrated multidrug resistance. Retrospective analyses of 154 cases for which medical records were fully available showed that the most common cause of infection was primary bloodstream infection (134 cases), of which 128 were related to intravascular catheter use. The mortality on day 28 after the onset was independently associated with cerebrovascular disease, moderate to severe renal disease, the Pitt bacteremia score, and infection other than primary bloodstream infection but not with appropriate empiric antimicrobial therapy. Isolation of A. baumannii was significantly associated with septic shock but not with the 28-day mortality. These findings, obtained in a region where drug-resistant Acinetobacter strains were much less prevailing, indicated that non-baumannii Acinetobacter species were common pathogens, that the most predominant cause of invasive Acinetobacter infection was intravascular catheter-related infection, that virulence of A. baumannii might be higher than those of other species but its association with mortality was unclear, and that administration of broad-spectrum antibiotics targeting Acinetobacter species might be deferrable in a certain situation.
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Affiliation(s)
- Yoshihiko Kiyasu
- Department of Infectious Diseases, University of Tsukuba Hospital, Japan.
| | - Shigemi Hitomi
- Department of Infectious Diseases, University of Tsukuba Hospital, Japan
| | | | - Kazuhito Saito
- Department of Respiratory Diseases, Tsuchiura Kyodo General Hospital, Japan
| | - Hiroichi Ishikawa
- Department of Respiratory Medicine, Tsukuba Medical Center Hospital, Japan
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41
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Hamamoto Y, Tsuruoka S, Takata N, Ishikawa H, Nagasaki K, Mochizuki T. PO-130: Postoperative radiotherapy for high-risk head and neck squamous cell carcinoma. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(20)30472-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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42
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Noguchi M, Shitara K, Kawazoe A, Yamamoto D, Takii Y, Saito Y, Sato T, Horimatsu T, Ishikawa H, Ito Y, Ito M, Ikematsu H. A phase II trial of adjuvant chemoradiotherapy for patients with high-risk rectal submucosal invasive cancer after local resection. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz421.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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43
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Ishikawa H, Tsuji D, Miyagi T, Kawasaki Y, Yamamoto K, Nakao M, Nakagaki S, Hayashi T, Ayuhara H, Harada T, Tamaki S, Maeda A, Ohashi Y, Arakawa Y, Fujita Y, Miyamoto Y, Yano T, Tanaka R, Itou K. Irinotecan and cisplatin therapy-induced neutropenia as a prognostic factor in patients with extensive-disease small cell lung cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz420.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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44
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Katada C, Yokoyama T, Yano T, Oda I, Shimizu Y, Doyama H, Koike T, Takizawa K, Hirao M, Okada H, Ishikawa H, Yokoyama A, Muto M. Drinking alcohol, smoking, multiple dysplastic lesions and the risk of field cancerization of squamous cell carcinoma in the esophagus and head and neck region. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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45
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Seto J, Wada T, Suzuki Y, Ikeda T, Araki K, Umetsu Y, Ishikawa H, Mizuta K, Ahiko T. A case of laboratory cross-contamination of Mycobacterium tuberculosis identified using comparative genomics. Int J Tuberc Lung Dis 2019; 22:1239-1242. [PMID: 30236195 DOI: 10.5588/ijtld.18.0237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Two false-positive tuberculosis (TB) cases in Yamagata Prefecture, Japan, 2016. OBJECTIVE To report the effectiveness of comparative genomics of Mycobacterium tuberculosis for identification of cross-contamination cases. DESIGN Case report of laboratory cross-contamination. RESULTS Beginning with detection of an identical genotype in two M. tuberculosis strains using variable number of tandem repeat typing, we suspected M. tuberculosis cross-contamination of specimens collected in a mycobacteriology laboratory based on epidemiological investigations. This suspicion was confirmed using comparative genomics of the two M. tuberculosis strains and a strain from an epidemiologically unrelated specimen from the same batch as the two strains in the mycobacteriology laboratory. All strains had an identical genomic sequence with no single nucleotide variants. CONCLUSION Comparative genomics, which offers the highest discrimination power, is a potent tool for identifying laboratory cross-contamination using epidemiological investigations.
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Affiliation(s)
- J Seto
- Yamagata Prefectural Institute of Public Health, Yamagata
| | - T Wada
- Nagasaki University, Nagasaki
| | - Y Suzuki
- Yamagata Prefectural Institute of Public Health, Yamagata
| | - T Ikeda
- Yamagata Prefectural Institute of Public Health, Yamagata
| | - K Araki
- Murayama Public Health Center, Yamagata
| | - Y Umetsu
- Okitama Public Health Center, Yamagata
| | - H Ishikawa
- Shonai Public Health Center, Yamagata, Japan
| | - K Mizuta
- Yamagata Prefectural Institute of Public Health, Yamagata
| | - T Ahiko
- Yamagata Prefectural Institute of Public Health, Yamagata, Murayama Public Health Center, Yamagata
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46
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Mochizuki F, Iijima H, Watanabe A, Tanabe N, Sato S, Shiigai M, Fujiwara K, Shimada T, Ishikawa H, Kanazawa J, Yatagai Y, Masuko H, Sakamoto T, Muro S, Hizawa N. The Concavity of the Maximal Expiratory Flow-Volume Curve Reflects the Extent of Emphysema in Obstructive Lung Diseases. Sci Rep 2019; 9:13159. [PMID: 31511572 PMCID: PMC6739348 DOI: 10.1038/s41598-019-49591-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 08/16/2019] [Indexed: 01/07/2023] Open
Abstract
A concave-shaped maximal expiratory flow-volume (MEFV) curve is a spirometric feature in chronic obstructive pulmonary disease (COPD). The MEFV curve is characterized by an increase in the Obstructive Index, which is defined as a ratio of forced vital capacity to the volume-difference between two points of half of the peak expiratory flow on the MEFV curve. We hypothesized that the Obstructive Index would reflect the severity of emphysema in patients with COPD and asthma-COPD overlap (ACO). Thus, the aim of this retrospective study was to evaluate whether the Obstructive Index on spirometry is associated with the extent of emphysema on computed tomography (CT) in patients with COPD, ACO, and asthma (N = 65, 15, and 53, respectively). The percentage of low-attenuation volume (LAV%) and wall area (WA%) were measured on CT. The Obstructive Index was higher in patients with COPD and ACO than in those with asthma. Spearman correlation showed that a greater Obstructive Index was associated with a higher LAV%, but not WA%. Multivariate analysis showed that Obstructive Index was associated with LAV% (standardized β = 0.43, P < 0.0001) independent of other spirometric indices. The Obstructive Index is a useful spirometric index that reflects the extent of emphysema.
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Affiliation(s)
- Fumi Mochizuki
- Department of Respiratory Medicine, Tsukuba Medical Centre Hospital, Tsukuba, Japan.
| | - Hiroaki Iijima
- Department of Respiratory Medicine, Tsukuba Medical Centre Hospital, Tsukuba, Japan
| | - Azusa Watanabe
- Department of Radiology, Tsukuba Medical Centre Hospital, Tsukuba, Japan
| | - Naoya Tanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Susumu Sato
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masanari Shiigai
- Department of Radiology, Tsukuba Medical Centre Hospital, Tsukuba, Japan
| | - Keiji Fujiwara
- Department of Respiratory Medicine, Tsukuba Medical Centre Hospital, Tsukuba, Japan
| | - Takafumi Shimada
- Department of Respiratory Medicine, Tsukuba Medical Centre Hospital, Tsukuba, Japan
| | - Hiroichi Ishikawa
- Department of Respiratory Medicine, Tsukuba Medical Centre Hospital, Tsukuba, Japan
| | - Jun Kanazawa
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yohei Yatagai
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Hironori Masuko
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tohru Sakamoto
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Shigeo Muro
- Department of Respiratory Medicine, Nara Medical University, Kashihara, Japan
| | - Nobuyuki Hizawa
- Department of Pulmonary Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
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47
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Fukuda H, Yamashita A, Ishikawa H, Nagata N, Niihara M. MON-PO556: The Invention of Tongue Cover to Reduce Discomfort During Intake of Oral Nutritional Supplements. Clin Nutr 2019. [DOI: 10.1016/s0261-5614(19)32389-1] [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: 11/26/2022]
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48
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Nakamura M, Ohnishi K, Okumura T, Numajiri H, Murofushi K, Mizumoto M, Nonaka T, Ishikawa H, Sakurai H. Definitive Photon or Proton Radiotherapy for Oligo-recurrences at the Regional Lymph Nodes after Surgery in Patients with Non-Small Cell Lung Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2418] [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: 11/15/2022]
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49
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Suzuki H, Gretarsson H, Ishikawa H, Ueda K, Yang Z, Liu H, Kim H, Kukusta D, Yaresko A, Minola M, Sears JA, Francoual S, Wille HC, Nuss J, Takagi H, Kim BJ, Khaliullin G, Yavaş H, Keimer B. Spin waves and spin-state transitions in a ruthenate high-temperature antiferromagnet. Nat Mater 2019; 18:563-567. [PMID: 30911120 DOI: 10.1038/s41563-019-0327-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 02/26/2019] [Indexed: 06/09/2023]
Abstract
Ruthenium compounds serve as a platform for fundamental concepts such as spin-triplet superconductivity1, Kitaev spin liquids2-5 and solid-state analogues of the Higgs mode in particle physics6,7. However, basic questions about the electronic structure of ruthenates remain unanswered, because several key parameters (including Hund's coupling, spin-orbit coupling and exchange interactions) are comparable in magnitude and their interplay is poorly understood, partly due to difficulties in synthesizing large single crystals for spectroscopic experiments. Here we introduce a resonant inelastic X-ray scattering (RIXS)8,9 technique capable of probing collective modes in microcrystals of 4d electron materials. We observe spin waves and spin-state transitions in the honeycomb antiferromagnet SrRu2O6 (ref. 10) and use the extracted exchange interactions and measured magnon gap to explain its high Néel temperature11-16. We expect that the RIXS method presented here will enable momentum-resolved spectroscopy of a large class of 4d transition-metal compounds.
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Affiliation(s)
- H Suzuki
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany.
| | - H Gretarsson
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - H Ishikawa
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
- Institut für Funktionelle Materie und Quantentechnologien, Universität Stuttgart, Stuttgart, Germany
| | - K Ueda
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
- Department of Applied Physics, University of Tokyo, Tokyo, Japan
| | - Z Yang
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - H Liu
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - H Kim
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
- Department of Physics, Pohang University of Science and Technology, Pohang, South Korea
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, South Korea
| | - D Kukusta
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - A Yaresko
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - M Minola
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - J A Sears
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - S Francoual
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - H-C Wille
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
| | - J Nuss
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - H Takagi
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
- Institut für Funktionelle Materie und Quantentechnologien, Universität Stuttgart, Stuttgart, Germany
- Department of Physics, University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - B J Kim
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
- Department of Physics, Pohang University of Science and Technology, Pohang, South Korea
- Center for Artificial Low Dimensional Electronic Systems, Institute for Basic Science (IBS), Pohang, South Korea
| | - G Khaliullin
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany
| | - H Yavaş
- Deutsches Elektronen-Synchrotron DESY, Hamburg, Germany
- SLAC National Accelerator Laboratory, Menlo Park, CA, USA
| | - B Keimer
- Max-Planck-Institut für Festkörperforschung, Stuttgart, Germany.
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50
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Sekino Y, Okumura T, Fukumitsu N, Iizumi T, Miyauchi D, Mizoguchi N, Murofushi K, Ohnishi K, Mizumoto M, Nonaka T, Nakai K, Ishikawa H, Tsuboi K, Sakurai H. EP-1420 Utility of FIB-4 index for hepatocellular carcinoma patients treated with proton beam therapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31840-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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