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Watanabe K, Kawai H, Sato T, Natsui M, Inoue R, Kimura M, Yoko K, Sasaki S, Watanabe M, Tsukada Y, Terai S. Endoscopic treatment of Bouveret syndrome with a combination of electrohydraulic lithotripsy and balloon expansion: A case report. DEN Open 2023; 3:e232. [PMID: 36998350 PMCID: PMC10043357 DOI: 10.1002/deo2.232] [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] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/06/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023]
Abstract
Bouveret syndrome is a rare type of ileus caused by the impaction of gallstones passing through a cholecystoenteric fistula in the duodenum. Endoscopic treatment with minimally invasive procedures is preferable for patients with this syndrome, typically for elderly individuals with a high surgical risk. Conventional endoscopic techniques often fail to remove impacted stones that are generally large and occasionally solid. We report the case of an 88‐year‐old bedridden woman with severe dementia who presented with difficulty in breathing. The patient was diagnosed with aspiration pneumonia. In addition, computed tomography showed a cholecystoduodenal fistula and a gallstone 37 mm in diameter that impacted the duodenal bulb. Bouveret syndrome was diagnosed on the basis of the computed tomography findings. The impacted stone was too large and hard to split with standard endoscopic lithotripsy using grasping forceps, mechanical lithotripter, polypectomy snare, basket catheter, and electrohydraulic lithotripsy (EHL). However, EHL with a dual‐channel therapeutic endoscope was achieved to drill a narrow hole approximately 20 mm deep into the stone, in four sessions. The stone was subsequently split by inflating the balloon, which was inserted into the hole, to 10 mm in diameter at 3 atm. All the split stones were spontaneously excreted during defecation after a few days. If the gallstone is too hard to fragment by endoscopic EHL alone, a combination of EHL and balloon expansion might be a useful alternative.
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Affiliation(s)
- Kotaro Watanabe
- Department of Internal MedicineNiigata Prefectural Shibata HospitalNiigataJapan
| | - Hirokazu Kawai
- Department of Internal MedicineNiigata Prefectural Shibata HospitalNiigataJapan
- Department of Internal MedicineNiigata Prefectural Kamo HospitalNiigataJapan
| | - Toshifumi Sato
- Department of Internal MedicineNiigata Prefectural Shibata HospitalNiigataJapan
- Department of GastroenterologySaiseikai Niigata HospitalNiigataJapan
| | - Masaaki Natsui
- Department of Internal MedicineNiigata Prefectural Shibata HospitalNiigataJapan
| | - Ryosuke Inoue
- Department of Internal MedicineNiigata Prefectural Shibata HospitalNiigataJapan
| | - Mayuki Kimura
- Department of Internal MedicineNiigata Prefectural Shibata HospitalNiigataJapan
| | - Kazumi Yoko
- Department of Internal MedicineNiigata Prefectural Shibata HospitalNiigataJapan
| | - Syun‐ya Sasaki
- Department of Internal MedicineNiigata Prefectural Shibata HospitalNiigataJapan
| | - Masashi Watanabe
- Department of Internal MedicineNiigata Prefectural Shibata HospitalNiigataJapan
| | - Yoshihisa Tsukada
- Department of Internal MedicineNiigata Prefectural Shibata HospitalNiigataJapan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
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2
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Nomura M, Okamura H, Horie Y, Yap CK, Emmanouil C, Uwai S, Kawai H. Effects of antifouling compounds on the growth of macroalgae Undaria pinnatifida. Chemosphere 2023; 312:137141. [PMID: 36343734 DOI: 10.1016/j.chemosphere.2022.137141] [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] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/01/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
Seaweeds are some of the principal primary producers of marine environments, and they are important ecological elements of coastal ecosystems. The effects of harmful chemicals on seaweeds may adversely affect coastal ecosystems, hence we aimed to develop a new phytotoxicity test using the gametophytes of a common temperate kelp species, Undaria pinnatifida (KU-1630), for the widely used antifouling chemical substances Cybutryne, Diuron, Cu2+, and Zn2+. Toxicity to gametophytes of U. pinnatifida was assessed by comparing the relative growth rate (RGR) at the logarithmic growth phase. Fragmentation method, initial algal biomass, photon irradiance, and adhesive period were investigated for developing optimal test conditions. Cybutryne exposure tests were performed with seven replicates and control, the RGR ranging from 0.17 to 0.19, while mean 7-day EC50 and no observed effect concentration (NOEC) were 5.1 μg/L and 1.8 μg/L, respectively. The 7-day EC50 for other antifoulants was 14 μg/L for Diuron, 17 μg/L for Cu2+, and 1500 μg/L for Zn2+. This test method demonstrated high sensitivity and reproducibility, and it may be added to the routine methods used for toxicity evaluation of hazardous chemicals.
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Affiliation(s)
- M Nomura
- Graduate School of Maritime Sciences, Kobe University, Fukaeminami-machi, Higashinada-ku, Kobe, 658-0022, Japan
| | - H Okamura
- Research Center for Inland Seas, Kobe University, Fukaeminami-machi, Higashinada-ku, Kobe, 658-0022, Japan.
| | - Y Horie
- Research Center for Inland Seas, Kobe University, Fukaeminami-machi, Higashinada-ku, Kobe, 658-0022, Japan
| | - C K Yap
- Department of Biology, Faculty of Science, Universiti Putra Malaysia, 43400, UPM Serdang, Selangor, Malaysia
| | - C Emmanouil
- School of Spatial Planning and Development, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - S Uwai
- Research Center for Inland Seas, Kobe University, Fukaeminami-machi, Higashinada-ku, Kobe, 658-0022, Japan
| | - H Kawai
- Research Center for Inland Seas, Kobe University, Fukaeminami-machi, Higashinada-ku, Kobe, 658-0022, Japan
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3
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Kawai H, Sato T, Natsui M, Watanabe K, Inoue R, Kimura M, Yoko K, Sasaki SY, Watanabe M, Ohashi T, Tsukahara A, Tanaka N, Tsukada Y. Mirizzi Syndrome Type IV Successfully Treated with Peroral Single-operator Cholangioscopy-guided Electrohydraulic Lithotripsy: A Case Report with Literature Review. Intern Med 2022; 61:3513-3519. [PMID: 35569988 PMCID: PMC9790796 DOI: 10.2169/internalmedicine.9526-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
A 76-year-old man presented with liver dysfunction and intrahepatic bile duct dilatation. Imaging studies showed two large stones that had become impacted in the common hepatic duct, which was fused with the gallbladder. The patient was diagnosed with Mirizzi syndrome type IV. Hepaticojejunostomy and stone removal failed due to dense gallbladder adhesions involving the right hepatic artery. The bile flow was temporarily restored; however, the patient experienced cholangitis 16 months later. The stones were extracted via peroral single-operator cholangioscopy (SOC)-guided electrohydraulic lithotripsy. This is the first case in which stones were completely removed by SOC-guided treatment in a patient with Mirizzi syndrome type IV.
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Affiliation(s)
- Hirokazu Kawai
- Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Japan
| | - Toshifumi Sato
- Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Japan
| | - Masaaki Natsui
- Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Japan
| | - Kotaro Watanabe
- Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Japan
| | - Ryosuke Inoue
- Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Japan
| | - Mayuki Kimura
- Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Japan
| | - Kazumi Yoko
- Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Japan
| | - Syun-Ya Sasaki
- Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Japan
| | - Masashi Watanabe
- Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Japan
| | - Taku Ohashi
- Department of Surgery, Niigata Prefectural Shibata Hospital, Japan
| | | | - Norio Tanaka
- Department of Surgery, Niigata Prefectural Shibata Hospital, Japan
| | - Yoshihisa Tsukada
- Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Japan
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4
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Kawai H, Naruse H, Sarai M, Kato Y, Sato Y, Motoyama S, Ishii J, Morimoto S, Izawa H. ACE values in the diagnosis of sarcoidosis. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In clinical practice, we often encounter the patients with sarcoidosis showing relatively high in the normal range of serum angiotensin-converting enzyme (ACE) value.
Purpose
We aimed to examine the serum ACE value of the patients with sarcoidosis and determine the new cut-off value for detecting the patients with sarcoidosis.
Methods and results
We retrospectively examined all 3781 subjects (51.1% men, 60.1±17.0 y.o.) in whom ACE was measured for any reasons including suspected sarcoidosis between 2009 and 2020 in our hospital. Of 293 patients with sarcoidosis, 101, 212, 84, and 88 were diagnosed as sarcoidosis in heart, lung, skin, and eyes, respectively. After excluding 477 patients taking ACE inhibitor and/or immunosuppression agent or those with any diseases affecting serum ACE levels, we analyzed 3304 subjects including 215 with sarcoidosis. Serum ACEs were 19.6 IU/L [IQR, 15.1–31.5] in the subjects with sarcoidosis and 10.7 [8.4–16.5] in those without (P<0.01). In ROC curve analysis of ACE for diagnosis of sarcoidosis, the cut-off point was 14.7 IU/L and the AUC was 0.865. When we used the current cut-off of 21.4 or new cut-off value of 14.7, sensitivity, specificity, PPV, NPV, and accuracy were shown in Table. Finally, they were divided into four groups based on the presence of cardiac and/or extra cardiac sarcoidosis, ACE values in Group A, B, C, and D were 17.9, 20.9, 18.6, and 10.7, respectively (Figure 1).
Conclusion(s)
In the current cut-off value of serum ACE, sensitivity for detecting sarcoidosis was comparatively low, though positive predictive value was low when the new-cut-off value was used in our study. Further examinations may be needed for the patients suspected sarcoidosis with relatively high ACE in the normal range.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Kawai
- Fujita Health University , Toyoake , Japan
| | - H Naruse
- Fujita Health University , Toyoake , Japan
| | - M Sarai
- Fujita Health University , Toyoake , Japan
| | - Y Kato
- Fujita Health University , Toyoake , Japan
| | - Y Sato
- Fujita Health University , Toyoake , Japan
| | - S Motoyama
- Fujita Health University , Toyoake , Japan
| | - J Ishii
- Fujita Health University , Toyoake , Japan
| | - S Morimoto
- Fujita Health University , Toyoake , Japan
| | - H Izawa
- Fujita Health University , Toyoake , Japan
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5
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Shimura T, Zaharieva E, Sasatani M, Kawai H, Kamiya K, Ushiyama A. ACTIVATION OF HUMAN FIBROBLASTS BY CHRONIC RADIATION RATHER THAN ACUTE RADIATION. Radiat Prot Dosimetry 2022; 198:1098-1103. [PMID: 36083750 DOI: 10.1093/rpd/ncac065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 03/22/2022] [Accepted: 04/06/2022] [Indexed: 06/15/2023]
Abstract
Cancer-associated fibroblast (CAF), an activated type of fibroblast, is a major stromal cell that contributes to tumor initiation and development in the tumor microenvironment (TME). We previously reported that fractionated radiation rather than acute radiation causes progressive damage to mitochondria and increases the generation of reactive oxygen species, playing an important role in the fibroblast activation in normal tissue injury. Activated fibroblasts then become CAF by interacting with tumor cells, promoting tumor growth in vivo. We here examined the chronic radiation effect on fibroblast activation. Acute radiation (<2.5 Gy) did not increase alpha-Smooth muscle actin, a CAF marker expression in healthy human cells, whereas chronic radiation (2.5 Gy) did. It can be concluded that the induction of fibroblast activation changes across acute radiation, fractionated radiation, and chronic radiation depending on the irradiation technique. This study highlights that radiation activates fibroblasts, playing a role in radiation-related tumor development via TME formation.
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Affiliation(s)
- T Shimura
- Department of Environmental Health, National Institute of Public Health, Wako, Saitama, 351-0197, Japan
| | - E Zaharieva
- Department of Experimental Oncology, Research, Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 784-8553, Japan
| | - M Sasatani
- Department of Experimental Oncology, Research, Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 784-8553, Japan
| | - H Kawai
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 734-8553, Japan
| | - K Kamiya
- Department of Experimental Oncology, Research, Center for Radiation Genome Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, 784-8553, Japan
| | - A Ushiyama
- Department of Environmental Health, National Institute of Public Health, Wako, Saitama, 351-0197, Japan
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Sakamaki A, Takamura M, Sakai N, Watanabe Y, Arao Y, Kimura N, Setsu T, Abe H, Yokoo T, Kamimura H, Tsubata S, Waguri N, Ishikawa T, Kawai H, Sugitani S, Sato T, Funakoshi K, Watanabe M, Igarashi K, Kamimura K, Tsuchiya A, Aoyagi Y, Terai S. Longitudinal increase in albumin-bilirubin score is associated with non-malignancy-related mortality and quality of life in patients with liver cirrhosis. PLoS One 2022; 17:e0263464. [PMID: 35113969 PMCID: PMC8812983 DOI: 10.1371/journal.pone.0263464] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/19/2022] [Indexed: 02/08/2023] Open
Abstract
Due to the developments in the treatment for hepatitis, it is possible to prevent the progression of liver fibrosis and improve patients’ prognosis even if it has already led to liver cirrhosis (LC). Consequently, a two-step study was conducted. To begin with, a retrospective study was conducted to identify the potential predictors of non-malignancy-related mortality from LC. Then, we prospectively analyzed the validity of these parameters as well as their association with patients’ quality of life. In the retrospective study, 89 cases were included, and the multivariate Cox regression analysis indicated that age (P = 0.012), model for end-stage liver disease (MELD) score (P = 0.012), and annual rate of change of the albumin–bilirubin (ALBI) score (P < 0.001) were significantly associated with LC prognosis. In the prospective study, 70 patients were included, and the patients were divided into cirrhosis progression and non-progression groups. The univariate logistic regression analysis indicated the serum procollagen type III N-terminal peptide level (P = 0.040) and MELD score (P = 0.010) were significantly associated with the annual rate of change of the ALBI score. Furthermore, the mean Chronic Liver Disease Questionnaire score worsened from 5.3 to 4.9 in the cirrhosis progression group (P = 0.034). In conclusion, a longitudinal increase in the ALBI score is closely associated with non-malignancy-related mortality and quality of life.
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Affiliation(s)
- Akira Sakamaki
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- * E-mail:
| | - Masaaki Takamura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Division of Gastroenterology and Hepatology, JA Niigata Kouseiren Nagaoka Chuo General Hospital, Niigata, Japan
| | - Norihiro Sakai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Yusuke Watanabe
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of Preemptive Medicine for Digestive Diseases and Healthy Active Life, School of Medicine, Niigata University, Niigata, Japan
| | - Yoshihisa Arao
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Naruhiro Kimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Toru Setsu
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hiroyuki Abe
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Takeshi Yokoo
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of Preemptive Medicine for Digestive Diseases and Healthy Active Life, School of Medicine, Niigata University, Niigata, Japan
| | - Hiroteru Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Shunsuke Tsubata
- Department of Gastroenterology and Hepatology, Tachikawa General Hospital, Niigata, Japan
| | - Nobuo Waguri
- Department Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
| | - Toru Ishikawa
- Division of Gastroenterology and Hepatology, Saiseikai Niigata Hospital, Niigata, Japan
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Niigata, Japan
| | - Soichi Sugitani
- Department of Gastroenterology and Hepatology, Tachikawa General Hospital, Niigata, Japan
- Department of Internal Medicine, Murakami General Hospital, Niigata, Japan
| | - Tomomi Sato
- Division of Gastroenterology and Hepatology, JA Niigata Kouseiren Nagaoka Chuo General Hospital, Niigata, Japan
- Department of Internal Medicine, Joetsu General Hospital, Niigata, Japan
| | - Kazuhiro Funakoshi
- Division of Gastroenterology and Hepatology, Niigata Prefectural Hospital, Niigata, Japan
| | - Masashi Watanabe
- Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Niigata, Japan
| | - Kentarou Igarashi
- Department Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
- Division of Gastroenterology and Hepatology, Mitsuke City Hospital, Niigata, Japan
| | - Kenya Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Department of General Medicine, School of Medicine, Niigata University, Niigata, Japan
| | - Atsunori Tsuchiya
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Yutaka Aoyagi
- Division of Gastroenterology and Hepatology, JA Niigata Medical Center, Niigata, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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7
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Miwa K, Ahn JK, Akazawa Y, Aramaki T, Ashikaga S, Callier S, Chiga N, Choi SW, Ekawa H, Evtoukhovitch P, Fujioka N, Fujita M, Gogami T, Harada T, Hasegawa S, Hayakawa SH, Honda R, Hoshino S, Hosomi K, Ichikawa M, Ichikawa Y, Ieiri M, Ikeda M, Imai K, Ishikawa Y, Ishimoto S, Jung WS, Kajikawa S, Kanauchi H, Kanda H, Kitaoka T, Kang BM, Kawai H, Kim SH, Kobayashi K, Koike T, Matsuda K, Matsumoto Y, Nagao S, Nagatomi R, Nakada Y, Nakagawa M, Nakamura I, Nanamura T, Naruki M, Ozawa S, Raux L, Rogers TG, Sakaguchi A, Sakao T, Sako H, Sato S, Shiozaki T, Shirotori K, Suzuki KN, Suzuki S, Tabata M, Taille CDL, Takahashi H, Takahashi T, Takahashi TN, Tamura H, Tanaka M, Tanida K, Tsamalaidze Z, Ukai M, Umetsu H, Wada S, Yamamoto TO, Yoshida J, Yoshimura K. Precise Measurement of Differential Cross Sections of the Σ^{-}p→Λn Reaction in Momentum Range 470-650 MeV/c. Phys Rev Lett 2022; 128:072501. [PMID: 35244436 DOI: 10.1103/physrevlett.128.072501] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/13/2022] [Accepted: 01/13/2022] [Indexed: 06/14/2023]
Abstract
The differential cross sections of the Σ^{-}p→Λn reaction were measured accurately for the Σ^{-} momentum (p_{Σ}) ranging from 470 to 650 MeV/c at the J-PARC Hadron Experimental Facility. Precise angular information about the Σ^{-}p→Λn reaction was obtained for the first time by detecting approximately 100 reaction events at each angular step of Δcosθ=0.1. The obtained differential cross sections show a slightly forward-peaking structure in the measured momentum regions. The cross sections integrated for -0.7≤cosθ≤1.0 were obtained as 22.5±0.68 [statistical error(stat.)] ±0.65 [systematic error(syst.)] mb and 15.8±0.83(stat)±0.52(syst) mb for 470<p_{Σ}(MeV/c)<550 and 550<p_{Σ}(MeV/c)<650, respectively. These results show a drastic improvement compared with past measurements of the hyperon-proton scattering experiments. They will play essential roles in updating the theoretical models of the baryon-baryon interactions.
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Affiliation(s)
- K Miwa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - J K Ahn
- Department of Physics, Korea University, Seoul 02841, Korea
| | - Y Akazawa
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - T Aramaki
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - S Ashikaga
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - S Callier
- OMEGA Ecole Polytechnique-CNRS/IN2P3, 3 rue Michel-Ange, 75794 Paris 16, France
| | - N Chiga
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - S W Choi
- Department of Physics, Korea University, Seoul 02841, Korea
| | - H Ekawa
- High Energy Nuclear Physics Laboratory, RIKEN, Wako 351-0198, Japan
| | - P Evtoukhovitch
- Joint Institute for Nuclear Research (JINR), Dubna, Moscow Region 141980, Russia
| | - N Fujioka
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - M Fujita
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - T Gogami
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - T Harada
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - S Hasegawa
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - S H Hayakawa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - R Honda
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - S Hoshino
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - K Hosomi
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - M Ichikawa
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
- Meson Science Laboratory, Cluster for Pioneering Research, RIKEN, Wako 351-0198, Japan
| | - Y Ichikawa
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - M Ieiri
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - M Ikeda
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - K Imai
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - Y Ishikawa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - S Ishimoto
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - W S Jung
- Department of Physics, Korea University, Seoul 02841, Korea
| | - S Kajikawa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - H Kanauchi
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - H Kanda
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - T Kitaoka
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - B M Kang
- Department of Physics, Korea University, Seoul 02841, Korea
| | - H Kawai
- Department of Physics, Chiba University, Chiba 263-8522, Japan
| | - S H Kim
- Department of Physics, Korea University, Seoul 02841, Korea
| | - K Kobayashi
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - T Koike
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - K Matsuda
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - Y Matsumoto
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - S Nagao
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - R Nagatomi
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - Y Nakada
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - M Nakagawa
- High Energy Nuclear Physics Laboratory, RIKEN, Wako 351-0198, Japan
| | - I Nakamura
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - T Nanamura
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - M Naruki
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - S Ozawa
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - L Raux
- OMEGA Ecole Polytechnique-CNRS/IN2P3, 3 rue Michel-Ange, 75794 Paris 16, France
| | - T G Rogers
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - A Sakaguchi
- Department of Physics, Osaka University, Toyonaka 560-0043, Japan
| | - T Sakao
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - H Sako
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - S Sato
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - T Shiozaki
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - K Shirotori
- Research Center for Nuclear Physics (RCNP), Osaka University, Ibaraki 567-0047, Japan
| | - K N Suzuki
- Department of Physics, Kyoto University, Kyoto 606-8502, Japan
| | - S Suzuki
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - M Tabata
- Department of Physics, Chiba University, Chiba 263-8522, Japan
| | - C D L Taille
- OMEGA Ecole Polytechnique-CNRS/IN2P3, 3 rue Michel-Ange, 75794 Paris 16, France
| | - H Takahashi
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - T Takahashi
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - T N Takahashi
- Nishina Center for Accelerator-based Science, RIKEN, Wako 351-0198, Japan
| | - H Tamura
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - M Tanaka
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - K Tanida
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - Z Tsamalaidze
- Joint Institute for Nuclear Research (JINR), Dubna, Moscow Region 141980, Russia
- Georgian Technical University (GTU), Tbilisi 0175, Georgia
| | - M Ukai
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
- Institute of Particle and Nuclear Studies (IPNS), High Energy Accelerator Research Organization (KEK), Tsukuba 305-0801, Japan
| | - H Umetsu
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - S Wada
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - T O Yamamoto
- Advanced Science Research Center (ASRC), Japan Atomic Energy Agency (JAEA), Tokai, Ibaraki 319-1195, Japan
| | - J Yoshida
- Department of Physics, Tohoku University, Sendai 980-8578, Japan
| | - K Yoshimura
- Department of Physics, Okayama University, Okayama 700-8530, Japan
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8
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Niwa Y, Tominaga K, Kawata Y, Kobayashi T, Mizuwasa T, Takahashi K, Sato H, Kohisa J, Abe S, Kamimura K, Yokoyama J, Kawai H, Sugino H, Umezu H, Hirai Y, Nakano M, Shimada Y, Kameyama H, Wakai T, Terai S. Intestinal duplication diagnosed preoperatively with double-balloon enteroscopy: an extremely rare case report and literature review. Clin J Gastroenterol 2022; 15:381-387. [DOI: 10.1007/s12328-022-01596-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/14/2022] [Indexed: 11/30/2022]
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9
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Miwa K, Nanamura T, Sakao T, Ahn JK, Akazawa Y, Aramaki T, Ashikaga S, Callier S, Chiga N, Chiga N, Choi SW, Ekawa H, Evtoukhovitch P, Fujioka N, Fujita M, Gogami T, Harada T, Hasegawa S, Hayakawa SH, Honda R, Hoshino S, Hosomi K, Ichikawa M, Ichikawa Y, Ieiri M, Ikedai M, Imai K, Ishikawa Y, Ishimoto S, Jung WS, Kajikawa S, Kanauchi H, Kanda H, Kitaoka T, Kang BM, Kawai H, Kim SH, Kobayashi K, Koike T, Matsuda K, Matsumoto Y, Nagao S, Nagatomi R, Nakada Y, Nakagawa M, Nakamura I, Naruki M, Ozawa S, Raux L, Rogers TG, Sakaguchi A, Sako H, Sato S, Shiozaki T, Shirotori K, Suzuki KN, Suzuki S, Tabata M, Taille CDL, Takahashi H, Takahashi T, Takahashi TN, Tamura H, Tanaka M, Tanida K, Tsamalaidze Z, Ukai M, Umetsu H, Wada S, Yamamoto TO, Yoshida J, Yoshimura K. Recent progress and future prospects of hyperon nucleon scattering experiment. EPJ Web Conf 2022. [DOI: 10.1051/epjconf/202227104001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
A new hyperon-proton scattering experiment, dubbed J-PARC E40, was performed to measure differential cross sections of the Σ+p, Σ−p elastic scatterings and the Σ−p → Λn scattering by identifying a lot of Σ particles in the momentum ranging from 0.4 to 0.8 GeV/c produced by the π±p → K+Σ± reactions. We successfully measured the differential cross sections of these three channels with a drastically improved accuracy with a fine angular step. These new data will become important experimental constraints to improve the theories of the two-body baryon-baryon interactions. Following this success, we proposed a new experiment to measure the differential cross sections and spin observables by using a highly polarized Λ beam for providing quantitative information on the ΛN interaction. The results of three Σp channels and future prospects of the Λp scattering experiment are described.
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10
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Motegi S, Yokoo T, Nozawa R, Azumi R, Kawata Y, Ogawa K, Setsu T, Mizuno KI, Nishino K, Umezu H, Kawai H, Suda T, Terai S. Long-term survival of 11 years with multidisciplinary therapy for hepatocellular carcinoma metastasis to the ovary and peritoneum: a case report. Clin J Gastroenterol 2021; 14:1211-1220. [PMID: 33978943 PMCID: PMC8298212 DOI: 10.1007/s12328-021-01434-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 05/02/2021] [Indexed: 02/07/2023]
Abstract
We herein report a rare case of HCC metastases to the ovary and peritoneum in a 61-year-old female patient who has achieved 11-year survival with multidisciplinary therapy. The patient was diagnosed with HCC during balloon angioplasty performed for Budd-Chiari syndrome in 1994 and underwent partial hepatectomy twice. Five years after the second hepatectomy, allochronic recurrence of a single nodule detected in S8 was treated by radiofrequency ablation, followed by percutaneous ethanol injection therapy and stereotactic body radiotherapy. However, her α-fetoprotein level rose to 1862 ng/mL within one year and computed tomography revealed a large pelvic tumor suggesting HCC metastasis to the ovary. The subsequent laparotomy revealed one 11-cm left ovarian tumor, one small right ovarian nodule, and numerous peritoneal nodules. Bilateral salpingo-oophorectomy and peritoneal resection of as many nodules as possible were performed. Combination therapy with intravenous 5-fluorouracil plus cisplatin and ramucirumab monotherapy effectively suppressed tumor progression with maintenance of hepatic functional reserve, and she has achieved long-term survival of 11 years, illustrating that multidisciplinary therapy with favorable hepatic functional reserve maintenance can contribute to long-term survival in HCC with extrahepatic spread.
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Affiliation(s)
- Satoko Motegi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Takeshi Yokoo
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan.
- Department of Preemptive Medicine for Digestive Diseases and Healthy Active Life, School of Medicine, Niigata University, Niigata, Niigata, Japan.
| | - Ryosuke Nozawa
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Rie Azumi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Yuzo Kawata
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Kohei Ogawa
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Toru Setsu
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Ken-Ichi Mizuno
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Koji Nishino
- Department of Obstetrics and Gynecology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Hajime Umezu
- Division of Pathology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Hirokazu Kawai
- Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Shibata, Niigata, Japan
| | - Takeshi Suda
- Department of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine Niigata University Hospital, Minamiuonuma, Niigata, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
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11
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Nakano O, Kawai H, Kobayashi T, Kohisa J, Ikarashi S, Hayashi K, Yokoyama J, Terai S. Rapid decline in visceral adipose tissue over 1 month is associated with poor prognosis in patients with unresectable pancreatic cancer. Cancer Med 2021; 10:4291-4301. [PMID: 33993635 PMCID: PMC8267120 DOI: 10.1002/cam4.3964] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 04/12/2021] [Accepted: 04/15/2021] [Indexed: 01/06/2023] Open
Abstract
Background Involuntary weight loss related to cachexia is common in patients with advanced cancer, but the association between body composition changes and survival is still unclear in pancreatic cancer. Methods We retrospectively reviewed the clinical outcomes of 55 patients with advanced pancreatic cancer undergoing palliative therapy or best supportive care (BSC). The skeletal muscle index (SMI), visceral adipose tissue index (VATI), subcutaneous adipose tissue index (SATI), and visceral to subcutaneous adipose tissue area ratio (VSR) were calculated based on the cross‐sectional area on two sets of computed tomography images obtained at cancer diagnosis and 1 month later before treatment. The prognostic value of body composition indexes at diagnosis and the changes in those indexes over 1 month was then evaluated. Results In total, 45 patients (81.8%) received chemotherapy, chemoradiation, or radiation therapy, whereas the remaining patients underwent BSC. There were 27 patients (49.1%) who had low SMI at cancer diagnosis. Univariate analysis showed no significant associations between the baseline body composition indexes including SMI, VATI, SATI, and VSR and survival. Meanwhile, male sex (HR, 2.79; 95% CI, 1.16–6.71, p = 0.022) and higher decrease in VATI over 1 month (HR, 2.41; 95% CI, 1.13–5.13, p = 0.023) were identified as independent risk factors for mortality in multivariate analysis. Conclusion Rapid decline in VAT over 1 month is closely associated with poorer survival in unresectable advanced pancreatic cancer. A short‐term assessment of body composition changes may be a rational approach to predict prognosis in these patients.
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Affiliation(s)
- Oki Nakano
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.,Department of Internal Medicine, Nagaoka Chuo General Hospital, Nagaoka, Japan
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.,Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Shibata, Japan
| | - Takamasa Kobayashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.,Department of Gastroenterology, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Junji Kohisa
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.,Department of Gastroenterology, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Satoshi Ikarashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kazunao Hayashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Junji Yokoyama
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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12
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Shimizu D, Kataoka M, Okutani D, Watanabe K, Kawai H, Harita S. P06.02 Prognostic Factors and Strategies for Metachronous Second Primary Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Tsuboi M, Suzuki H, Kawai H, Ejima T, Mitsuishi F. Vascular sound visualization system is useful for monitoring and surveillance of vascular access. J Vasc Access 2021; 23:390-397. [PMID: 33586508 DOI: 10.1177/1129729821993984] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUNDS Vascular access (VA) is a lifeline for maintenance hemodialysis patients. Monitoring and surveillance of VA, therefore, play an important role for maintaining VA patency. Surveillance needs special apparatus to estimate the VA function, while, monitoring including physical examination does not usually need such devices but highly skill-dependent and qualitative. PURPOSE We report the clinical utility in monitoring and surveillance of VA using a newly developed electronic stethoscope and vascular sound visualization application. METHODS One hundred eight patients participated in the study. The vascular sounds were collected using the electronic stethoscope, converted into digital data, sent wirelessly to a personal computer, and then calculated. The units for the calculated intensity of the vascular sound were decibel [dB]. The intensity, however, was normalized as INDEX values ranging from 0 to 99 for practical use. Correlation between INDEX and the mean flow volume (mFV) and resistance index (RI) of brachial artery measured by Doppler ultrasound sonography were examined for VA surveillance. INDEX was continually measured at each dialysis session in ten patients who underwent the angioplasty for VA monitoring. RESULTS INDEX significantly correlated with the mFV (coefficient of correlation value = 0.68, p < 0.001) and RI (coefficient of correlation value = -0.51, p < 0.001) of brachial artery. Using the calculated cut-off values, the accuracy of INDEX for the diagnosis of AVF dysfunction ranged from 66% to 82%. INDEX attained the peak just after the angioplasty of culprit lesions and gradually decreased from one patient to another. CONCLUSION These results suggest that vascular sound visualization system can be useful in VA monitoring and surveillance for detecting and predicting the access stenosis.
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Affiliation(s)
| | | | | | - Toru Ejima
- Kaikoukai Anjo Kyoritsu Clinic, Aichi, Japan
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14
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Kamimura H, Sato T, Natsui K, Kobayashi T, Yoshida T, Kamimura K, Tsuchiya A, Murayama T, Yokoyama J, Kawai H, Takamura M, Terai S. Molecular Mechanisms and Treatment of Sarcopenia in Liver Disease: A Review of Current Knowledge. Int J Mol Sci 2021; 22:ijms22031425. [PMID: 33572604 PMCID: PMC7867020 DOI: 10.3390/ijms22031425] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 12/24/2022] Open
Abstract
Sarcopenia is characterized by progressive and generalized loss of skeletal muscle mass and strength that occurs with aging or in association with various diseases. The condition is prevalent worldwide and occurs more frequently in patients with chronic diseases owing to the intrinsic relationship of muscles with glucose, lipid, and protein metabolism. Liver cirrhosis is characterized by the progression of necro-inflammatory liver diseases, which leads to fibrosis, portal hypertension, and a catabolic state, which causes loss of muscle tissue. Sarcopenia is of significant concern in the state of liver cirrhosis because sarcopenia has been associated with higher mortality, increased hospital admissions, worse post-liver transplant outcomes, decreased quality of life, and increased risk for other complications associated with cirrhosis. Therefore, sarcopenia is also an important feature of liver cirrhosis, representing a negative prognostic factor and influencing mortality. An increased understanding of sarcopenia could lead to the development of novel therapeutic approaches that could help improve the cognitive impairment of cirrhotic patients; therefore, we present a review of the mechanisms and diagnosis of sarcopenia in liver disease and existing therapeutic approaches.
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Affiliation(s)
- Hiroteru Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (T.S.); (K.N.); (T.K.); (T.Y.); (K.K.); (A.T.); (J.Y.); (H.K.); (M.T.); (S.T.)
- Nutrition Support Team, Niigata University Medical and Dental Hospital, Niigata 951-8510, Japan;
- Correspondence: ; Tel.: +81-25-227-2207
| | - Takeki Sato
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (T.S.); (K.N.); (T.K.); (T.Y.); (K.K.); (A.T.); (J.Y.); (H.K.); (M.T.); (S.T.)
| | - Kazuki Natsui
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (T.S.); (K.N.); (T.K.); (T.Y.); (K.K.); (A.T.); (J.Y.); (H.K.); (M.T.); (S.T.)
| | - Takamasa Kobayashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (T.S.); (K.N.); (T.K.); (T.Y.); (K.K.); (A.T.); (J.Y.); (H.K.); (M.T.); (S.T.)
| | - Tomoaki Yoshida
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (T.S.); (K.N.); (T.K.); (T.Y.); (K.K.); (A.T.); (J.Y.); (H.K.); (M.T.); (S.T.)
| | - Kenya Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (T.S.); (K.N.); (T.K.); (T.Y.); (K.K.); (A.T.); (J.Y.); (H.K.); (M.T.); (S.T.)
| | - Atsunori Tsuchiya
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (T.S.); (K.N.); (T.K.); (T.Y.); (K.K.); (A.T.); (J.Y.); (H.K.); (M.T.); (S.T.)
| | - Toshiko Murayama
- Nutrition Support Team, Niigata University Medical and Dental Hospital, Niigata 951-8510, Japan;
| | - Junji Yokoyama
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (T.S.); (K.N.); (T.K.); (T.Y.); (K.K.); (A.T.); (J.Y.); (H.K.); (M.T.); (S.T.)
- Nutrition Support Team, Niigata University Medical and Dental Hospital, Niigata 951-8510, Japan;
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (T.S.); (K.N.); (T.K.); (T.Y.); (K.K.); (A.T.); (J.Y.); (H.K.); (M.T.); (S.T.)
| | - Masaaki Takamura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (T.S.); (K.N.); (T.K.); (T.Y.); (K.K.); (A.T.); (J.Y.); (H.K.); (M.T.); (S.T.)
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata 951-8510, Japan; (T.S.); (K.N.); (T.K.); (T.Y.); (K.K.); (A.T.); (J.Y.); (H.K.); (M.T.); (S.T.)
- Nutrition Support Team, Niigata University Medical and Dental Hospital, Niigata 951-8510, Japan;
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Takahashi S, Mine T, Kawai H, Takai K, Yoshikawa F, Takada M, Fujita K, Nishibori Y, Maruyama T. Conduction gaps after pulmonary vein isolation due to high contact force ablation in patients with atrial fibrillation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0444] [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
Catheter ablation for atrial fibrillation (AF) with high contact force (CF) has been reported to lead to the gaps after pulmonary vein isolation (PVI), and the appearance of the gaps depends on the site in the left atrium (LA).
Purpose
The aim of this study is to clarify the relationship between the gaps appearance and high CF.
Methods
In the clinical study, 74 consecutive patients (39 males, age 71±9, 46 with paroxysmal AF) underwent conventional PVI with a point-by-point radiofrequency (RF) ablation using a CF sensing catheter (TactiCath SETM). RF energy (J), number of RF point, Lesion index (LSI), force-time integral (FTI), average CF (g), and the degree of LA depression with high CF were evaluated. In the experimental study (figure), the relationship between the ablation area and the degree of depression with high CF using bovine left ventricular wall.
Results
In the clinical study, the gaps were found in 175 of 1182 sites after first path PVI ablation. The CF in the gap sites was higher than without the gap sites in RPV roof, anterior RSPV and anterior RPV carina (18.9±6.8 vs 15.0±5.7g p=0.0262, 26.4±11.6 vs 19.5±6.0g p=0.0029, 22.7±6.4 vs 19.1±5.5g, p=0.0161). Meanwhile, there were no differences in RF energy, number of RF point, LSI, FTI. High CF (≥30g) showed a depression of 3 mm or more in only RPV roof and anterior RPV (figure). In the experimental study, the ablation range narrowed as the indentation deepened with more than 30g CF (r=0.6417, p=0.0625).
Conclusion
Catheter ablation for AF with high contact force might lead to the gaps in RPV roof and anterior RPV site by the reduction of the ablation area due to depression caused by the pressure.
Extension of each contact force
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | - T Mine
- Hyogo College of Medicine, cardiovascular division, Hyogo, Japan
| | - H Kawai
- Kawasaki Hospital, Kobe, Japan
| | - K Takai
- Kawasaki Hospital, Kobe, Japan
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Sukegawa S, Saika M, Tamamura R, Nakano K, Takabatake K, Kawai H, Nagatsuka H, Furuki Y. Clinical retrospective study of dental implant removal: do patients who require implant removal desire implant prosthesis again? Med Oral Patol Oral Cir Bucal 2020; 25:e784-e790. [PMID: 33037809 PMCID: PMC7648916 DOI: 10.4317/medoral.23789] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 03/04/2020] [Accepted: 09/03/2020] [Indexed: 12/17/2022] Open
Abstract
Background This study investigated the causes of dental implant removal due to complications, and examined whether patients who had dental implant removal desired re-implant prosthesis treatments.
Material and Methods A retrospective case–control study was conducted on patients who had their dental implants removed. We investigated whether the removed dental implant was replaced with other implant prostheses. Age, sex, diabetes, smoking, implant site distribution, reason for implant removal, and blade and root-form implants were categorized as predictive variables. The outcome variable was desire for re-implantation or use of other prosthetic methods after implant removal. A logistic regression model was created to identify patient factors that could predict the re-implantation of dental prostheses after implant removal.
Results A total of 215 dental implants were removed from 143 patients. The most common reason for implant removal was peri-implantitis that was identified in 165 implants. After implant removal, re-implantation was performed in 98 implants (45.6%). Bivariate analyses showed that age, diabetes, implant type, and reason for implant removal were associated with the desire for re-implanted prostheses. The multiple regression model revealed that age, implant type, and reason for implant removal were associated with an increased desire for re-implant prostheses after implant removal.
Conclusions Re-implantation of prostheses after the removal of dental implants was desired by patients who were younger, had implants placed in the root form, and had implants removed due to prosthetic-related complications. Key words:Dental implant removal, complications, implant prosthesis, retrospective study, re-implantation.
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Affiliation(s)
- S Sukegawa
- Department of Oral and Maxillofacial Surgery, Kagawa Prefectural Central Hospital, 1-2-1 Asahi-machi, Takamatsu, Kagawa 760-8557, Japan
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Ohtake H, Ishii J, Nishimura H, Kawai H, Muramatsu T, Harada M, Motoyama S, Watanabe E, Ozaki Y, Iwata M. Prospective validation of 0-hour/1-hour algorithm using high-sensitivity cardiac troponin I in Japanese patients presenting to emergency department. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The diagnostic performance of 0-hour/1-hour algorithm using high-sensitivity cardiac troponin I (hsTnI) for non-ST-segment elevation myocardial infarction (NSTEMI) has not been evaluated in an Asian population.
Purpose
We aimed to prospectively validate the 0-hour/1-hour algorithm using hsTnI in a Japanese population.
Method
We enrolled 754 Japanese patients (mean age of 70 years, 395 men) presenting to our emergency department with symptoms suggestive of NSTEMI. The hsTnI concentration was measured using the Siemens ADVIA Centaur hsTnI assay at presentation and after 1 hour. Patients were divided into three groups according to the algorithm: hsTnI below 3 ng/L (only applicable if chest pain onset >3 hours) or below 6 ng/L and delta 1 hour below 3 ng/L were the “rule-out” group; hsTnI at least 120 ng/L or delta 1 hour at least 12 ng/L were in the “rule-in” group; the remaining patients were classified as the “observe” group. Based on the Fourth Universal Definition of Myocardial Infarction, the final diagnosis was adjudicated by 2 independent cardiologists using all available information, including coronary angiography, coronary computed tomography, and follow-up data. Safety of rule-out was quantified by the negative predictive value (NPV) for NSTEMI, accuracy of rule-in by the positive predictive value (PPV), and overall efficacy by the proportion of patients triaged towards rule-out or rule-in within 1 hour.
Results
Prevalence of NSTEMI was 6.5%. The safety of rule-out (NPV 100%), accuracy of rule-in (PPV 26%), and overall efficacy (54%) were shown in Figure.
Conclusion
The 0-hour/1-hour algorithm using hsTnI is very safe and effective in triaging Japanese patients with suspected NSTEMI.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- H Ohtake
- Fujita Health University, Toyoake, Japan
| | - J Ishii
- Fujita Health University, Toyoake, Japan
| | | | - H Kawai
- Fujita Health University, Toyoake, Japan
| | | | - M Harada
- Fujita Health University, Toyoake, Japan
| | - S Motoyama
- Fujita Health University, Toyoake, Japan
| | - E Watanabe
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
| | - M Iwata
- Fujita Health University, Toyoake, Japan
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18
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Ohta M, Ozaki Y, Toriya T, Nagasaya R, Takatsu H, Yoshiki Y, Hashimoto Y, Ishikawa M, Kawai H, Muramatsu T, Naruse H, Takahashi H, Ishii J, Izawa H. Five-year major adverse cardiac and cerebrovascular events of patients with lipid core abutting lumen (LCAL) on integrated-backscatter intravascular ultrasound undergoing PCI with current DES. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Percutaneous Coronary Intervention (PCI) using the new generation drug-eluting stent (DES) has been extremely reduced target lesion revascularization (TLR) in recent years. However, a high incidence of non-target lesion-related cardiovascular events in patients undergoing PCI is an important problem to be solved. According to the previous findings, patients with vulnerable plaques particularly have a high recurrence of cardiovascular events. Little studies, however, has been done to examine the relationship between plaque characteristics on intravascular imaging in a target lesion and non-target lesion-related cardiovascular events.
Purpose
The main objective of this study is to investigate the five-year major adverse cardiac and cerebrovascular events (MACCE) of patients with lipid core abutting lumen (LCAL) on integrated backscatter intravascular ultrasound (IB-IVUS) in a target lesion undergoing PCI with current DES.
Methods and results
Between February 2010 and September 2013, in total 780 patients with ischemic heart disease undergoing PCI, 166 target lesions in 166 consecutive patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) and stable angina pectoris (SAP) undergoing IVUS-guided PCI were studied.
Plaque characteristics in all target lesions were analyzed by three-dimensional IB-IVUS system using the mechanical IVUS catheter. Our previous study has found that LCAL which is defined as a lipid pool directly in contact with the lumen visualizes the thin fibrous cap of less than 75μm on optical coherence tomography (OCT). On the basis of this data, LCAL at minimal lumen area (MLA) site was identified.
In total, 39 patients had lesions with LCAL at MLA site (LCAL(+)), and 127 patients had those without LCAL (LCAL(−)).
The primary endpoint was defined as MACCE, including cardiovascular death, non-fatal myocardial infarction, non-fatal stroke and non-TLR for the new lesion during a median follow up of five years. The MACCE occurred significantly higher in the LCAL(+) than in the LCAL(−) (38.5% vs. 17.3%; p<0.005). And the Kaplan-Meier estimates have shown that the cumulative incidence of MACCE was significantly higher in the LCAL(+) than in the LCAL(−) (log rank test, p=0.041). Additionally, after adjustment for confounders, gender, prior PCI and LCAL was the independent predictors for the MACCE of patients undergoing PCI with current DES.
Furthermore, after adding LCAL to a baseline model with established factors consisting of age, gender, diabetes mellitus, prior PCI and percentage lipid volume on IB-IVUS, the net reclassification (p<0.002) and integrated discrimination improvement (p<0.004) significantly improved compared to baseline model alone.
Conclusions
In this study, it has become clear that LCAL on IB-IVUS is likely to be a surrogate marker of MACCE in patients undergoing PCI with current DES.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Ohta
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
| | - T Toriya
- Fujita Health University, Toyoake, Japan
| | - R Nagasaya
- Fujita Health University, Toyoake, Japan
| | - H Takatsu
- Fujita Health University, Toyoake, Japan
| | - Y Yoshiki
- Fujita Health University, Toyoake, Japan
| | | | - M Ishikawa
- Sakurabashi-Watanabe Hospital, Cardiology, Osaka, Japan
| | - H Kawai
- Fujita Health University, Toyoake, Japan
| | | | - H Naruse
- Fujita Health University, Toyoake, Japan
| | | | - J Ishii
- Fujita Health University, Toyoake, Japan
| | - H Izawa
- Fujita Health University Second Hospital, Cardiology, Nagoya, Japan
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19
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Ishii J, Takahashi H, Nishimura H, Fujiwara W, Ohta M, Kawai H, Muramatsu T, Harada M, Yamada A, Naruse H, Motoyama S, Watanabe E, Izawa H, Ozaki Y. Circulating presepsin (soluble CD14 subtype) as a novel marker of mortality in patients treated at medical cardiac intensive care units. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Presepsin, a subtype of soluble CD14, is an inflammatory marker, which largely reflects monocyte activation. The association between presepsin levels and mortality in patients treated at medical cardiac intensive care units (CICUs) remains poorly known.
Objective
We aimed to understand the prognostic value of presepsin levels on admission to medical CICUs for mortality.
Methods
We prospectively studied 1636 heterogeneous patients (median age; 71 years) treated at medical (non-surgical) CICUs. Patients with stage 5 chronic kidney disease (estimated glomerular filtration rate [eGFR] <15 mL/min/1.73 m2) were excluded. Acute coronary syndrome was present in 46% of the patients, and acute decompensated heart failure in 36%. Upon admission, baseline plasma presepsin levels were measured. The primary endpoint was all-cause death.
Results
During a mean follow-up period of 44.6 months after admission, there were 323 (19.7%) deaths. Patients who died were older (median: 75 vs. 71 years, P<0.0001); had higher levels of presepsin (194 vs. 110 pg/mL, P<0.0001), B-type natriuretic peptide (BNP: 520 vs. 144 pg/mL, P<0.0001), high-sensitivity C-reactive protein (hsCRP: 4.7 vs. 2.0 mg/L, P<0.0001), and sequential organ failure assessment (SOFA) score (3 vs. 2, P<0.0001); and had lower levels of eGFR (55 vs. 69 mL/min/1.73m2, P<0.0001) and left ventricular ejection fraction (46% vs. 52%, P<0.0001) than those of the survivors. Multivariate Cox regression analyses revealed presepsin levels as independent predictors of all-cause deaths when assessed as either continuous variables (relative risk [RR] 3.33 per 10-fold increment; P<0.0001) or variables categorized according to quartiles (RR quartile 4 vs. 1, 3.60; P<0.0001). Quartiles of presepsin levels were significantly (P<0.0001) associated with increased risk of mortality (Figure). Adding presepsin levels to a baseline model that included established risk factors, BNP, and hsCRP further enhanced reclassification (P=0.009) and discrimination (P=0.0008) beyond that of the baseline model alone.
Conclusions
Circulating concentration of presepsin on admission may be a potent and independent predictor of mortality, and it may improve the risk stratification of patients admitted at medical CICUs.
Presepsin quartiles and mortality
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- J Ishii
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Takahashi
- Division of Statistics, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Nishimura
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - W Fujiwara
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - M Ohta
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Kawai
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - T Muramatsu
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Harada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - A Yamada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Naruse
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - S Motoyama
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - E Watanabe
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Izawa
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Y Ozaki
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
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20
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Ikarashi S, Kawai H, Hayashi K, Kohisa J, Sato T, Nozawa Y, Morita S, Oka H, Sato M, Aruga Y, Yoshikawa S, Terai S. Risk factors for walled-off necrosis associated with severe acute pancreatitis: A multicenter retrospective observational study. J Hepatobiliary Pancreat Sci 2020; 27:887-895. [PMID: 32506672 DOI: 10.1002/jhbp.787] [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] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 05/02/2020] [Accepted: 06/01/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND This study aimed to identify the risk factors for walled-off necrosis (WON) associated with severe acute pancreatitis (SAP). METHODS This retrospective study was conducted in eight institutions in Japan between 2014 and 2017. We analyzed WON incidence, patient characteristics, and risk factors for WON in patients with SAP who were observed for >28 days. RESULTS Of 134 patients with SAP, WON occurred in 40 (29.9%). Male sex (P = .045), body mass index (BMI) ≥25 (P < .001), post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (P = .020), and disseminated intravascular coagulation (DIC) (P = .001) were more frequent in the WON group than in the non-WON group. On admission, the frequency of white blood cell counts ≥ 12 000/µL (P = .037) and hypoenhanced pancreatic lesion on computed tomography (P = .047) were significantly higher in the WON group. In multivariate analysis, BMI ≥ 25 (odds ratio [OR] 5.73, 95% confidence interval [CI] 1.95-16.8; P = .002), post-ERCP (OR 8.08, 95% CI 1.57-41.7; P = .013), and DIC (OR 3.52, 95% CI 1.20-10.4; P = .022) were independent risk factors for WON. CONCLUSIONS High BMI, post-ERCP pancreatitis, and DIC are risk factors for the development of WON associated with SAP.
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Affiliation(s)
- Satoshi Ikarashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.,Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Shibata, Japan
| | - Kazunao Hayashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Junji Kohisa
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.,Department of Gastroenterology, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Toshifumi Sato
- Department of Internal Medicine, Niigata Prefectural Shibata Hospital, Shibata, Japan
| | - Yujiro Nozawa
- Department of Gastroenterology and Hepatology, Saiseikai Niigata Hospital, Niigata, Japan
| | - Shinichi Morita
- Department of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine Niigata University Hospital, Minami-Uonuma, Japan
| | - Hiromitsu Oka
- Department of Internal Medicine, Nagaoka Chuo General Hospital, Nagaoka, Japan
| | - Munehiro Sato
- Department of Gastroenterology and Hepatology, Niigata City General Hospital, Niigata, Japan
| | - Yukio Aruga
- Department of Internal Medicine, Niigata Prefectural Central Hospital, Joetsu, Japan
| | - Seiichi Yoshikawa
- Department of Gastroenterology, Nagaoka Red Cross Hospital, Nagaoka, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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21
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Ihdayhid AR, Motoyama S, Fujimoto S, Isa M, Nerlekar N, Kato E, Miyajima K, Comella A, Kamo Y, Sarai M, Kawai H, Arakita K, Hislop-Jambrich J, Cameron J, Ko B. P7 The impact of coronary calcification on diagnostic performance of workstation CT derived fractional flow reserve - a multicentre experience. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
On-site workstation based computed tomography derived fractional flow reserve (CT-FFR) is an emerging method to assess the vessel specific ischaemia in coronary artery disease (CAD). The impact of coronary calcification on its diagnostic performance is unknown.
Purpose
To evaluate the impact of coronary calcification on the diagnostic performance of reduced-order CT-FFR at detecting vessel specific ischaemia.
Methods
This is a retrospective pooled analysis of 141 patients with suspected CAD enrolled from 3 global centres who underwent CT-coronary angiography (CTA), onsite CT-FFR and invasive FFR. Coronary calcification was assessed by Agatston score (AS). The diagnostic performance of CT-FFR (≤0.8) and CTA (≥50%) in evaluation of vessel specific ischaemia (FFR ≤ 0.8) was assessed across AS quartiles (Q1-4). A comparison of diagnostic performance of the low to mid AS (Q1 to Q3) versus high AS (Q4) was performed.
Results
Mean age and median AS was 65.8 ± 9.9 and 327.3 (interquartile range = 78.5 – 798.1). Diagnostic accuracy, sensitivity and specificity of CT-FFR for low-mid AS (0-798) and high AS (799-4019) were 77.4% vs 82.9%; 78.9% vs 94.7%; 68.8% vs 76.5% respectively with no statistical difference between the two groups. The AUC for ischaemia of CT-FFR in low to mid AS was comparable with AUC in the high AS (0.76 [95% CI: 0.66-0.86] vs 0.84 [0.69-0.99]; P = 0.397). The AUC for ischemia for CT-FFR in both low to mid AS and high AS was significantly higher than for CTA (0.76 [0.66-0.86] vs 0.57 [0.50-0.64]; P = 0.003 and 0.84 [0.69-0.99] vs 0.48 [0.38-0.57]; P < 0.001 respectively).
Conclusion
On-site workstation CT-FFR demonstrated consistently high diagnostic performance in patients with high AS. Its diagnostic performance was superior when compared with significant stenosis assessment on CTA across all spectrum of Agatston scores.
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Affiliation(s)
- A R Ihdayhid
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Australia
| | - S Motoyama
- Fujita Health University, Department of Cardiology, Fujita, Japan
| | - S Fujimoto
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Isa
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Australia
| | - N Nerlekar
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Australia
| | - E Kato
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Miyajima
- Fujita Health University, Department of Cardiology, Fujita, Japan
| | - A Comella
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Australia
| | - Y Kamo
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Sarai
- Fujita Health University, Department of Cardiology, Fujita, Japan
| | - H Kawai
- Fujita Health University, Department of Cardiology, Fujita, Japan
| | - K Arakita
- Canon Medical Systems Japan, Otawara, Japan
| | | | - J Cameron
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Australia
| | - B Ko
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Australia
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22
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Miyajima K, Motoyama S, Sarai M, Kawai H, Takahashi H, Muramatsu T, Naruse H, Ishii J, Ozaki Y. P6178The optimal point of CT-FFR measurement in comparison with invasive FFR. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Currently, invasive fractional flow reserve (FFR), has become a gold standard to select patients requiring revascularization. Coronary computed tomography angiography (CTA) -derived FFR (FFRCT/CT-FFR) can be used for the management of coronary artery disease, which would be a gatekeeper of invasive coronary angiography. In most of the previous report to evaluate the diagnostic performance of FFRCT/CT-FFR, FFRCT/CT-FFR value was measured at the same point as the invasive FFR. Clinically, FFRCT/CT-FFR should be measured without the information of invasive FFR. However, optimal measurement point for CT-FFR has not been established yet.
Purpose
To assess the optimal measurement point of CT-FFR in comparison with invasive FFR as a gold standard.
Methods
CTA images scanned at 70–99% of R-R interval with 320 slice CT were screened. In the de-novo lesions with invasive FFR data were included in this study. Since calcified lesions could affect CT-FFR value, severe calcified lesions on CTA were excluded from the analysis. The CT-FFR analysis was performed by 2 cardiologists blinded to the results of the invasive FFR using a standard desktop computer and dedicated software. CT-FFR values could be provided at any point from ostium of coronary artery to the distal with vessel diameter of 1.8mm. To determine the optimal point for measurement of CT-FFR, CT-FFR values were obtained at 3 points in each coronary artery; 1) at the same point as invasive FFR; 2) lowest CT-FFR at distal point of coronary artery; 3) at 2.0 cm distal to the lesion. The diagnostic performance at each point was compared with invasive FFR.
Results
Fifty vessels of 44 patients (average age 68 years, male were 32) were included. Average Agatston score was 279.4. There was significant correlation between CT-FFR at each point and invasive FFR. CT-FFR at the same point as invasive FFR showed the good correlation with invasive FFR (R=0.641, 95% CI= 0.041–0.127, p<0.0001). Compared to the lowest CT-FFR at distal (R=0.608, 95% CI= 0.069–0.160, p<0.0001), CT-FFR at 2.0 cm distal to the lesion (R=0.604, 95% CI= 0.007–0.061, p<0.0001) revealed better correlation with invasive FFR. Sensitivity, specificity, positive and negative predictive value at each point were 92.8 / 93.3 / 81.8; 75.0 / 57.1 / 94.2; 61.9 / 48.2 / 60.0; and 96.0 / 95.2 / 84.6, respectively. Diagnostic accuracy showed that CT-FFR at 2cm distal to the lesion (0.84) was similar to CT-FFR at the same point as invasive FFR (0.80), and it was better than far distal (0.68) to detect invasive FFR derived ischemia.
Conclusions
CT-FFR was feasible to detect invasive FFR derived ischemia at the same point.
CT-FFR at 2.0 cm distal to the lesion showed higher diagnostic performance compared with CT-FFR measured at the far distal. CT-FFR measurement at 2.0 cm distal to the lesion would be a optimal position clinically.
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Affiliation(s)
- K Miyajima
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - S Motoyama
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - M Sarai
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - H Kawai
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - H Takahashi
- Fujita Health University, Division of Medical Statistics, Toyoake, Japan
| | - T Muramatsu
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - H Naruse
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - J Ishii
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Department of Cardiology, Toyoake, Japan
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23
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Ihdayhid AR, Fujimoto S, Motoyama S, Comella A, Kato E, Miyajima K, Isa M, Kamo Y, Sarai M, Kawai H, Arakita K, Hislop-Jambrich J, Cameron J, Seneviratne S, Ko B. P6187Multicentre diagnostic performance of on-site workstation CT derived fractional flow reserve. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
On-site workstation based computed tomography derived fractional flow reserve (CT-FFR) is an emerging method to assess vessel specific ischaemia in coronary artery disease (CAD). Global data on its diagnostic performance when compared with CT coronary angiography (CTA) is limited.
Purpose
To evaluate the on-site multicentre diagnostic performance of reduced-order CT-FFR at detecting vessel specific ischaemia.
Method
This is a retrospective pooled analysis of 141 patients (204 vessels) with suspected CAD enrolled from 3 global centres who underwent CTA, onsite CT-FFR and invasive FFR. On-site CT-FFR was performed using a reduced order model on a standard desktop computer with dedicated software. The per vessel diagnostic performance of CT-FFR (≤0.8) for vessel specific ischemia (FFR≤0.8) was compared with CTA (≥50% stenosis).
Results
Mean age was 65.8±9.9, 70.7% were male. FFR significant stenosis was present in 34.3% (70/204) of vessels. Pearson correlation of CT-FFR for invasive FFR was 0.52, P<0.001. Bland Altman analysis demonstrated a mean difference of 0.06±0.15 (95% limits of agreement −0.22 to 0.35). Per vessel diagnostic accuracy, sensitivity and specificity of CT-FFR and CTA were 79.9% vs 53.5%; 78.6% vs 85.7%; 80.6% vs 35.9% respectively. Diagnostic performance as assessed by area under the receiver operator curve (AUC) for CT FFR was superior to CTA (0.82 [95% CI 0.76–0.88] vs 0.61 [0.55–0.67]; P<0.001).
Conclusion
On-site workstation CT-FFR demonstrated high per vessel diagnostic performance and was superior when compared with CTA in assessment of vessel specific ischaemia as assessed by invasive FFR in a multicentre setting.
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Affiliation(s)
- A R Ihdayhid
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Australia
| | - S Fujimoto
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - S Motoyama
- Fujita Health University, Department of Cardiology, Fujita, Japan
| | - A Comella
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Australia
| | - E Kato
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - K Miyajima
- Fujita Health University, Department of Cardiology, Fujita, Japan
| | - M Isa
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Australia
| | - Y Kamo
- Juntendo University Graduate School of Medicine, Department of Cardiovascular Medicine, Tokyo, Japan
| | - M Sarai
- Fujita Health University, Department of Cardiology, Fujita, Japan
| | - H Kawai
- Fujita Health University, Department of Cardiology, Fujita, Japan
| | - K Arakita
- Canon Medical Systems Japan, Otawara, Japan
| | | | - J Cameron
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Australia
| | - S Seneviratne
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Australia
| | - B Ko
- Monash Cardiovascular Research Centre, Monash University and MonashHeart, Monash Health, Melbourne, Australia
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24
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Kawai H, Motoyama S, Miyajima K, Hoshino M, Ohta M, Takahashi H, Ishii J, Muramatsu T, Sarai M, Ozaki Y. P6171Role of myocardial mass for identifying FFR-verified ischemia and determining therapeutic strategy. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Conventional noninvasive approach using coronary CT angiography (CTA) focusing on only coronary artery lesions remains mismatch in identifying functional ischemia and determining indication for coronary revascularization.
Purpose
We aimed to assess the usefulness of CT-verified myocardial mass for identifying FFR-verified myocardial ischemia and determining the indication of coronary revascularization after FFR examination.
Methods
We examined 244 vessels with intermediate stenoses (50 to 90% stenosis visually on CTA) in 216 patients (mean age 69.2±9.2, 166 men) who underwent both coronary CTA and invasive FFR. In addition to coronary stenosis severity and plaque characteristics on visual, minimal lumen diameter (MLD), minimal lumen area (MLA), plaque volume, the entire myocardial volume of the target vessel (MTV) and that exposed to ischemia (FFR ≤0.80) (myocardial volume of ischemia: MVI) were evaluated. Additionally, therapeutic strategy after FFR was recorded.
Results
Of 244 vessels, myocardial ischemia (FFR ≤0.80) was shown in 99 (40.6%). MTV was larger in the patients with FFR-verified ischemia than those without (53.3±19.2 vs. 41.5±21.6, P<0.001); MLA, plaque burden (PB) and percentage of aggregated plaque volume (%APV) were also associated with ischemia. The area under the curves (AUCs) of MLA, PB, %APV, and MTV were 0.69, 0.67, 0.64, and 0.71, respectively. Addition of MTV to a model with coronary stenosis on visual, MLA, PB, and %APV improved C-index (from 0.72 to 0.79, P<0.01), net reclassification improvement (NRI) (0.71, P<0.01), and integrated discrimination improvement (IDI) (0.10, P<0.01). Of 99 vessels with FFR ≤0.80, MVI was larger in the vessels with early revascularization after FFR than those without (38.8 vs. 29.1, P=0.01).
Conclusions
The measurement of myocardial mass improves the diagnostic performance of coronary CTA for the identification of coronary arteries with FFR-verified ischemia. Furthermore, it is associated with therapeutic strategy for the diseased vessels after FFR examination.
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Affiliation(s)
- H Kawai
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - S Motoyama
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - K Miyajima
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - M Hoshino
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - M Ohta
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - H Takahashi
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - J Ishii
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - T Muramatsu
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - M Sarai
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Department of Cardiology, Toyoake, Japan
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Motoyama S, Sarai M, Kawai H, Miyajima K, Muramatsu T, Takahashi H, Naruse H, Ishii J, Ozaki Y. P2240CTA derived plaque characteristics and cardiac events in deferred lesions by invasive FFR. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Fractional flow reserve (FFR) based strategy for coronary artery disease (CAD) is widely accepted. However, cardiac events could occur at deferred lesions after FFR. We previous reported that CT derived high risk plaque (HRP) and residual stenosis were the independent predictors of cardiac events.
Purpose
The purpose of this study was to investigate if plaque characteristics on CTA could predict cardiac events in deferred lesions after FFR.
Methods
We included 211 vessels of 193 patients who were deferred revascularization after CTA and invasive FFR. The presence of HRP and the stenosis grading on CTA were analyzed.
Results
Median follow-up period after CTA was 623 days (IQR 302–945). HRP and obstructive stenosis were detected in 58 (27.5%) and 87 (41.2%) lesions, respectively. Cardiac events were occurred in 10 lesions at 440±167 days in average (range: 150–770 days). Multivaliate cox hazard regression analysis revealed that HRP (HR8.01, p=0.0032) and obstructive stenosis with ≥70% (HR 34.93, p<0.0001) were the independent predictors of cardiac events after adjusted for age, sex, and FFR≤0.8. Of 21 lesions with both HRP and obstructive stenosis, 29% lesions resulted in cardiac events in 2 years.
Conclusions
Even in the deferred lesions by invasive FFR, lesions with HRP and obstructive stenosis showed high rate of cardiac events. These lesions should be treated with intensive medical therapy to prevent cardiac events.
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Affiliation(s)
- S Motoyama
- Fujita Health University, Toyoake, Japan
| | - M Sarai
- Fujita Health University, Toyoake, Japan
| | - H Kawai
- Fujita Health University, Toyoake, Japan
| | - K Miyajima
- Fujita Health University, Toyoake, Japan
| | | | | | - H Naruse
- Fujita Health University, Toyoake, Japan
| | - J Ishii
- Fujita Health University, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Toyoake, Japan
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Fujita T, Kataoka M, Suemori K, Okutani D, Watanabe K, Kawai H, Harita S. EP1.15-13 Prognosis of Colorectal Cancer Cases That Underwent Lung and Liver Metastasectomy and Therapeutic Outcomes of Brain Metastasis. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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27
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Kawai H, Sarai M, Kato Y, Naruse H, Ishii J, Morimoto S, Izawa H, Toyama H, Ozaki Y. P1806Diagnosis of isolated cardiac sarcoidosis using FDG-PET/CT on the basis of new guidelines. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0558] [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
Introduction
Sarcoidosis is a systemic inflammatory disease which can involve any organs. The reported prevalence of isolated cardiac sarcoidosis (CS) varies widely because of the lack of an agreed definition of isolated CS (iCS). ICS was newly defined in the new guidelines for CS by Japanese Circulation Society.
Purpose
We aimed to examine the diagnostic accuracy of 18F-FDG PET/CT and the ratio of iCS in the whole CS by reviewing the patients with suspected CS undergoing the whole-body and cardiac FDG PET/CT scans.
Methods
We retrospectively reviewed 74 consecutive patients undergoing 18F-FDG PET/CT from 2013 to 2018 (mean age 60±14 years, 37 male) without the initiation of corticosteroid. Myocardial FDG uptake in CS was defined as a “focal” or “focal on diffuse” pattern. Systemic sarcoidosis (sCS) and iCS were diagnosed according to guidelines for the diagnosis and treatment of CS by Japanese Circulation Society. In short, iCS was diagnosed clinically when no clinical findings of sarcoidosis in any other organs and FDG uptake in heart were shown in addition to the following three of four criteria: high-grade atrioventricular block or fatal ventricular arrhythmia, structural abnormality, left ventricular contractile dysfunction, and delayed Gadolinium enhancement of myocardium on MRI.
Results
Of 31 patients with extra-cardiac sarcoidosis, 10 already met the diagnostic criteria of sCS before undergoing 18F-FDG PET/CT and 11 was newly diagnosed as sCS after FDG PET/CT. Of the remaining 43 without extra-cardiac sarcoidosis, 18 had FDG uptake in heart. Of 18 with FDG uptake in heart, iCS was diagnosed in 7, and sCS in 3 with extra-cardiac uptake of FDG as well as myocardium. Finally, 24 and 7 patients met the criteria of sCS and iCS based on the guideline, respectively. The sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of FDG PET/CT for CS including sCS and iCS were 90, 87, 88, 85, and 92%, respectively.
Conclusion
The ratio of iCS on the basis of new guidelines for diagnosis and treatment of CS was 22% of the whole CS.
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Affiliation(s)
- H Kawai
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - M Sarai
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - Y Kato
- Fujita Health University Bantane Hospital, Department of Cardiology, Nagoya, Japan
| | - H Naruse
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - J Ishii
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - S Morimoto
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - H Izawa
- Fujita Health University Bantane Hospital, Department of Cardiology, Nagoya, Japan
| | - H Toyama
- Fujita Health University, Department of Radiology, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Department of Cardiology, Toyoake, Japan
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Ishii J, Takahashi H, Nishimura T, Kawai H, Muramatsu T, Harada M, Yamada A, Naruse H, Hayashi M, Motoyama S, Sarai M, Watanabe E, Izawa H, Ozaki Y. P4620Circulating concentration of presepsin improves early prediction of short-term mortality in patients treated at medical cardiac intensive care units. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.1002] [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
Presepsin, a subtype of soluble CD14, is an inflammatory marker, which largely reflects monocytic activation. Presepsin appears to be an accurate diagnostic marker of sepsis, but its clinical significance remains unclear in cardiovascular disease.
Purpose
This prospective study aimed to investigate the predictive value of plasma presepsin levels on admission to medical (non-surgical) cardiac intensive care units (MCICUs) for short-term mortality.
Methods
We examined 1560 patients hospitalized in MCICUs and measured the baseline plasma presepsin levels at admission.
Results
Acute coronary syndrome was present in 46% of the patients, and acute decompensated heart failure in 36%. Before MCICUs admission, emergent coronary angiography or percutaneous coronary intervention was performed in 36%, mechanical ventilation was required for respiratory insufficiency in 2.1%, and intraaortic balloon pumps were needed for hemodynamic instability in 8.9%. During 6 months after admission, there were 113 (7.2%) deaths. Patients who died were older (median: 77 vs. 71 years, P<0.0001); had higher levels of presepsin (263 vs. 119 pg/mL, P<0.0001), B-type natriuretic peptide (BNP: 696 vs. 186 pg/mL, P<0.0001), high-sensitivity troponin T (hsTnT: 81 vs. 47 pg/mL, P=0.004), and high-sensitivity C-reactive protein (13.8 vs. 2.2 mg/L, P<0.0001); and had lower levels of estimated glomerular filtration rate (50 vs. 65 mL/min/1.73m2, P<0.0001) and left ventricular ejection fraction (43% vs. 51%, P<0.0001) than those of the survivors. In the multivariate Cox regression analysis, higher levels of presepsin (P=0.0002), BNP (P=0.04), and hsTnT (P=0.009) were all independent predictors of 6-month deaths. Quartiles of presepsin levels were associated with higher mortality rates within 6 months after admission (Table). Adding presepsin levels to a baseline model that included established risk factors, BNP, and hsTnT further enhanced reclassification (P=0.004) and discrimination (P=0.003) beyond that of the baseline model.
Mortality rates according to presepsin Presepsin quartile 1st 2nd 3rd 4th P value ≤80 pg/mL 81–124 pg/mL 125–232 pg/mL >232 pg/mL 1-month mortality 0.8% 2.0% 3.3% 8.0% <0.0001 6-month mortality 0.8% 3.8% 8.2% 16.3% <0.0001
Conclusions
Presepsin levels at admission could improve the prediction of short-term mortality in patients hospitalized at MCICUs.
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Affiliation(s)
- J Ishii
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Takahashi
- Division of Statistics, Fujita Health University School of Medicine, Toyoake, Japan
| | - T Nishimura
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Kawai
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - T Muramatsu
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Harada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - A Yamada
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Naruse
- Dept of Joint Research Laboratory of Clinical Medicine, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Hayashi
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - S Motoyama
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - M Sarai
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - E Watanabe
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
| | - H Izawa
- Dept of Cardiology, Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Y Ozaki
- Dept of Cardiology, Fujita Health University School of Medicine, Toyoake, Japan
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29
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Sakamaki A, Kamimura K, Fukui N, Watanabe H, Sakai N, Tominaga K, Mizuno K, Takamura M, Kawai H, Sugai T, Yamagiwa S, Someya T, Terai S. A case report of psychiatric symptoms following direct-acting antiviral and ribavirin combination therapy for chronic hepatitis C in a patient with innate anxiety. BMC Gastroenterol 2019; 19:85. [PMID: 31195993 PMCID: PMC6567614 DOI: 10.1186/s12876-019-1013-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 06/06/2019] [Indexed: 12/27/2022] Open
Abstract
Background Direct-acting antivirals (DAAs) result in a highly sustained virological response rate and better patient tolerance. However, this therapeutic approach may, on rare occasions, give rise to psychiatric symptoms. We describe a case requiring discontinuation of DAA and ribavirin combination therapy due to psychiatric symptoms in a patient with congenital anxious personality traits. The information summarized here will be helpful to physicians treating chronic hepatitis C virus (HCV) infection in patients with underlying psychiatric problems. Case presentation A 57-year-old Japanese woman diagnosed with chronic HCV infection was prescribed DAA and ribavirin combination therapy. She had a history of mild innate anxiety and development of psychiatric symptoms due to interferon (IFN) therapy 8 years prior, which subsided with discontinuation of the therapy. Similar psychiatric symptoms such as enervation, palpitations, an episode of hyperventilation, and consciousness disturbances with myotonia were observed after the administration of the antiviral agents. No abnormal findings related to her symptoms were observed on laboratory or imaging results. Psychiatrists diagnosed the patient as having a somatization disorder induced by the antiviral agents on the basis of innate anxiety. After the discontinuation of therapy, her symptoms gradually improved. Conclusions Although DAAs were not causative factors for psychiatric symptoms in phase 3 studies, a post-marketing study reported psychiatric symptoms such as depression in patients with underlying psychiatric problems. Our case suggests psychiatric symptoms might worsen after DAA and ribavirin administration in patients with underlying psychiatric disorders, and therefore, close monitoring is necessary for these patients, especially if they have a history of psychiatric symptoms after IFN.
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Affiliation(s)
- Akira Sakamaki
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata, 951-8510, Japan.
| | - Kenya Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata, 951-8510, Japan
| | - Naoki Fukui
- Division of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata, 951-8510, Japan
| | - Haruka Watanabe
- Division of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata, 951-8510, Japan
| | - Norihiro Sakai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata, 951-8510, Japan
| | - Kentaro Tominaga
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata, 951-8510, Japan
| | - Kenichi Mizuno
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata, 951-8510, Japan
| | - Masaaki Takamura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata, 951-8510, Japan
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata, 951-8510, Japan
| | - Takuro Sugai
- Division of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata, 951-8510, Japan
| | - Satoshi Yamagiwa
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata, 951-8510, Japan
| | - Toshiyuki Someya
- Division of Psychiatry, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata, 951-8510, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachidori, Chuo-ku, Niigata, 951-8510, Japan
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30
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Shekhar A, Chaudhry F, Kawai H, Adapoe M, Narula N, Strauss W, Petrov A, Heeger P, Narula J. 247Effectiveness of molecular imaging of programmed cell death with radiolabeled duramycin in focal apoptosis due to myocardial infarction versus diffuse apoptosis in cardiac transplant rejection. Eur Heart J Cardiovasc Imaging 2019. [DOI: 10.1093/ehjci/jez150.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- A Shekhar
- Mount Sinai School of Medicine, Cardiology, New York, United States of America
| | - F Chaudhry
- Mount Sinai School of Medicine, Cardiology, New York, United States of America
| | - H Kawai
- Mount Sinai School of Medicine, Cardiology, New York, United States of America
| | - M Adapoe
- Mount Sinai School of Medicine, Cardiology, New York, United States of America
| | - N Narula
- New York University School of Medicine, PATHOLOGY, New York, United States of America
| | - W Strauss
- Mount Sinai School of Medicine, Cardiology, New York, United States of America
| | - A Petrov
- Mount Sinai School of Medicine, Cardiology, New York, United States of America
| | - P Heeger
- Mount Sinai School of Medicine, Cardiology, New York, United States of America
| | - J Narula
- Mount Sinai School of Medicine, Cardiology, New York, United States of America
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31
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Watanabe Y, Tsuchiya A, Seino S, Kawata Y, Kojima Y, Ikarashi S, Starkey Lewis PJ, Lu W, Kikuta J, Kawai H, Yamagiwa S, Forbes SJ, Ishii M, Terai S. Mesenchymal Stem Cells and Induced Bone Marrow-Derived Macrophages Synergistically Improve Liver Fibrosis in Mice. Stem Cells Transl Med 2019; 8:271-284. [PMID: 30394698 PMCID: PMC6392382 DOI: 10.1002/sctm.18-0105] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 09/22/2018] [Indexed: 02/06/2023] Open
Abstract
We describe a novel therapeutic approach for cirrhosis using mesenchymal stem cells (MSCs) and colony-stimulating factor-1-induced bone marrow-derived macrophages (id-BMMs) and analyze the mechanisms underlying fibrosis improvement and regeneration. Mouse MSCs and id-BMMs were cultured from mouse bone marrow and their interactions analyzed in vitro. MSCs, id-BMMs, and a combination therapy using MSCs and id-BMMs were administered to mice with CCl4 -induced cirrhosis. Fibrosis regression, liver regeneration, and liver-migrating host cells were evaluated. Administered cell behavior was also tracked by intravital imaging. In coculture, MSCs induced switching of id-BMMs toward the M2 phenotype with high phagocytic activity. In vivo, the combination therapy reduced liver fibrosis (associated with increased matrix metalloproteinases expression), increased hepatocyte proliferation (associated with increased hepatocyte growth factor, vascular endothelial growth factor, and oncostatin M in the liver), and reduced blood levels of liver enzymes, more effectively than MSCs or id-BMMs monotherapy. Intravital imaging showed that after combination cell administration, a large number of id-BMMs, which phagocytosed hepatocyte debris and were retained in the liver for more than 7 days, along with a few MSCs, the majority of which were trapped in the lung, migrated to the fibrotic area in the liver. Host macrophages and neutrophils infiltrated after combination therapy and contributed to liver fibrosis regression and promoted regeneration along with administered cells. Indirect effector MSCs and direct effector id-BMMs synergistically improved cirrhosis along with host cells in mice. These studies pave the way for new treatments for cirrhosis. Stem Cells Translational Medicine 2019;8:271&284.
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Affiliation(s)
- Yusuke Watanabe
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
| | - Atsunori Tsuchiya
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
| | - Satoshi Seino
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
| | - Yuzo Kawata
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
| | - Yuichi Kojima
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
| | - Shunzo Ikarashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
| | - Philip J. Starkey Lewis
- Medical Research Council Centre for Regenerative MedicineThe University of EdinburghEdinburghUnited Kingdom
| | - Wei‐Yu Lu
- Medical Research Council Centre for Regenerative MedicineThe University of EdinburghEdinburghUnited Kingdom
| | - Junichi Kikuta
- Department of Immunology and Cell Biology, Graduate School of Medicine and Frontier BiosciencesOsaka UniversitySuitaJapan
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
| | - Satoshi Yamagiwa
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
| | - Stuart J. Forbes
- Medical Research Council Centre for Regenerative MedicineThe University of EdinburghEdinburghUnited Kingdom
| | - Masaru Ishii
- Department of Immunology and Cell Biology, Graduate School of Medicine and Frontier BiosciencesOsaka UniversitySuitaJapan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental SciencesNiigata UniversityNiigataJapan
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32
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Fujiwara Y, Suzuki H, Ogawa S, Kawai H, Hirano H, Watanabe Y, Ihara K, Obuchi S. TWO-YEAR CHANGE IN MONTREAL COGNITIVE ASSESSMENT AND RELATED PREDICTORS IN COMMUNITY-DWELLING ELDERLY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y Fujiwara
- Tokyo Metropolitan Institute of Gerontology
| | - H Suzuki
- Tokyo Metropolitan Institute of Gerontology
| | - S Ogawa
- Tokyo Metropolitan Institute of Gerontology
| | - H Kawai
- Tokyo Metropolitan Institute of Gerontology
| | - H Hirano
- Tokyo Metropolitan Institute of Gerontology
| | - Y Watanabe
- Tokyo Metropolitan Institute of Gerontology
| | - K Ihara
- Department of Public Health, Toho University School of Medicine
| | - S Obuchi
- Tokyo Metropolitan Institute of Gerontology, Japan
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33
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Sakaguchi Y, Kidokoro H, Ogawa C, Okai Y, Ito Y, Yamamoto H, Ohno A, Nakata T, Tsuji T, Nakane T, Kawai H, Kato K, Naganawa S, Natsume J. Longitudinal Findings of MRI and PET in West Syndrome with Subtle Focal Cortical Dysplasia. AJNR Am J Neuroradiol 2018; 39:1932-1937. [PMID: 30213810 DOI: 10.3174/ajnr.a5772] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/08/2018] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Despite the development of neuroimaging, identification of focal cortical dysplasia remains challenging. The purpose of this study was to show the longitudinal changes of MR imaging and FDG-PET in patients with West syndrome and subtle focal cortical dysplasia. MATERIALS AND METHODS Among 52 consecutive patients with West syndrome, 4 were diagnosed with subtle focal cortical dysplasia on 3T MR imaging. MR imaging and PET findings were evaluated longitudinally at onset and at 12 and 24 months of age. RESULTS At the onset of West syndrome, MR imaging demonstrated focal signal abnormalities of the subcortical white matter in 2 patients. In the other 2 patients, focal subcortical high-intensity signals became visible on follow-up T2WI as myelination progressed. PET at onset showed focal cortical hypometabolism in 3 patients, with 1 of these patients also having focal hypermetabolism and 1 having normal findings. On PET at 24 months, hypometabolism persisted in 2 patients and disappeared in 1, and hypermetabolism disappeared in 1. In 1 patient with normal MR imaging and PET findings at onset, focal hyperintensity and hypometabolism first appeared at 24 months of age. The findings on MR imaging and PET in these patients evolved differently with brain maturation and the clinical course. CONCLUSIONS Subtle focal cortical dysplasia can be undetectable on MR imaging at the onset of West syndrome and is not always accompanied by hypometabolism or hypermetabolism on PET. Longitudinal MR imaging and PET studies may be useful for detecting such lesions. Even in West syndrome with a congenital structural abnormality, PET findings evolve differently with brain maturation and the clinical condition.
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Affiliation(s)
- Y Sakaguchi
- From the Departments of Pediatrics (Y.S., H. Kidokoro, C.O., Y.O., Y.I., H.Y., A.O., T. Nakata, J.N.)
| | - H Kidokoro
- From the Departments of Pediatrics (Y.S., H. Kidokoro, C.O., Y.O., Y.I., H.Y., A.O., T. Nakata, J.N.).,Brain and Mind Research Center (H. Kidokoro, Y.I., H.Y., H. Kawai, S.N., J.N.), Nagoya University, Nagoya, Japan
| | - C Ogawa
- From the Departments of Pediatrics (Y.S., H. Kidokoro, C.O., Y.O., Y.I., H.Y., A.O., T. Nakata, J.N.)
| | - Y Okai
- From the Departments of Pediatrics (Y.S., H. Kidokoro, C.O., Y.O., Y.I., H.Y., A.O., T. Nakata, J.N.)
| | - Y Ito
- From the Departments of Pediatrics (Y.S., H. Kidokoro, C.O., Y.O., Y.I., H.Y., A.O., T. Nakata, J.N.).,Brain and Mind Research Center (H. Kidokoro, Y.I., H.Y., H. Kawai, S.N., J.N.), Nagoya University, Nagoya, Japan
| | - H Yamamoto
- From the Departments of Pediatrics (Y.S., H. Kidokoro, C.O., Y.O., Y.I., H.Y., A.O., T. Nakata, J.N.).,Brain and Mind Research Center (H. Kidokoro, Y.I., H.Y., H. Kawai, S.N., J.N.), Nagoya University, Nagoya, Japan
| | - A Ohno
- From the Departments of Pediatrics (Y.S., H. Kidokoro, C.O., Y.O., Y.I., H.Y., A.O., T. Nakata, J.N.)
| | - T Nakata
- From the Departments of Pediatrics (Y.S., H. Kidokoro, C.O., Y.O., Y.I., H.Y., A.O., T. Nakata, J.N.)
| | - T Tsuji
- Department of Pediatrics (T.T.), Okazaki City Hospital, Okazaki, Japan
| | - T Nakane
- Radiology (T. Nakane, H. Kawai, S.N.)
| | - H Kawai
- Radiology (T. Nakane, H. Kawai, S.N.).,Brain and Mind Research Center (H. Kidokoro, Y.I., H.Y., H. Kawai, S.N., J.N.), Nagoya University, Nagoya, Japan
| | - K Kato
- Radiological and Medical Laboratory Sciences (K.K.)
| | - S Naganawa
- Radiology (T. Nakane, H. Kawai, S.N.).,Brain and Mind Research Center (H. Kidokoro, Y.I., H.Y., H. Kawai, S.N., J.N.), Nagoya University, Nagoya, Japan
| | - J Natsume
- From the Departments of Pediatrics (Y.S., H. Kidokoro, C.O., Y.O., Y.I., H.Y., A.O., T. Nakata, J.N.) .,Developmental Disability Medicine (J.N.), Nagoya University Graduate School of Medicine, Nagoya, Japan.,Brain and Mind Research Center (H. Kidokoro, Y.I., H.Y., H. Kawai, S.N., J.N.), Nagoya University, Nagoya, Japan
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Matsuo K, Miayta T, Onishi T, Takaya T, Shimane A, Taniguchi Y, Yasaka Y, Kawai H. P2798Prognostic value of collagen type IV in patients with acutely decompensated heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy565.p2798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Matsuo
- Himeji Cardiovascular Center, cardiology, Himeji, Japan
| | - T Miayta
- Himeji Cardiovascular Center, cardiology, Himeji, Japan
| | - T Onishi
- Himeji Cardiovascular Center, cardiology, Himeji, Japan
| | - T Takaya
- Himeji Cardiovascular Center, cardiology, Himeji, Japan
| | - A Shimane
- Himeji Cardiovascular Center, cardiology, Himeji, Japan
| | - Y Taniguchi
- Himeji Cardiovascular Center, cardiology, Himeji, Japan
| | - Y Yasaka
- Himeji Cardiovascular Center, cardiology, Himeji, Japan
| | - H Kawai
- Himeji Cardiovascular Center, cardiology, Himeji, Japan
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Miyajima K, Motoyama S, Sarai M, Kawai H, Nagahara Y, Miyagi M, Takada K, Matsumoto R, Ito K, Takahashi H, Muramatsu T, Naruse H, Ishii J, Kondo T, Ozaki Y. 3281Clinical usefulness of CT-FFR and myocardial perfusion imaging in comparison with invasive FFR. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- K Miyajima
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - S Motoyama
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - M Sarai
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - H Kawai
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - Y Nagahara
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - M Miyagi
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - K Takada
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - R Matsumoto
- Fujita Health University, Department of Radiology, Toyoake, Japan
| | - K Ito
- Fujita Health University, Department of Radiology, Toyoake, Japan
| | - H Takahashi
- Fujita Health University, Division of Medical Statistics, Toyoake, Japan
| | - T Muramatsu
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - H Naruse
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - J Ishii
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - T Kondo
- Fujita Health University, Department of Cardiology, Toyoake, Japan
| | - Y Ozaki
- Fujita Health University, Department of Cardiology, Toyoake, Japan
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Kawai H, Ohta M, Motoyama S, Hashimoto Y, Nagahara Y, Hoshino M, Miyajima K, Ishikawa M, Okumura M, Naruse H, Takahashi H, Ishii J, Muramatsu T, Sarai M, Ozaki Y. 6182Does myocardial bridge assessed by coronary CT angiography predict vasospasm of left anterior descending? Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.6182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- H Kawai
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - M Ohta
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - S Motoyama
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - Y Hashimoto
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - Y Nagahara
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - M Hoshino
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - K Miyajima
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - M Ishikawa
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - M Okumura
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - H Naruse
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - H Takahashi
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - J Ishii
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - T Muramatsu
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - M Sarai
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
| | - Y Ozaki
- Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan
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Onishi T, Sawada T, Takahashi N, Uzu K, Inoue T, Taniguchi Y, Yasaka Y, Kawai H. P5444Association between Valvuloarterial Impedance and Cardiac Sympathetic Nerve Activity in Patients with Severe Aortic Stenosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- T Onishi
- Himeji Cardiovascular Center, Himeji, Japan
| | - T Sawada
- Himeji Cardiovascular Center, Himeji, Japan
| | | | - K Uzu
- Himeji Cardiovascular Center, Himeji, Japan
| | - T Inoue
- Himeji Cardiovascular Center, Himeji, Japan
| | | | - Y Yasaka
- Himeji Cardiovascular Center, Himeji, Japan
| | - H Kawai
- Himeji Cardiovascular Center, Himeji, Japan
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Imamura K, Shimane A, Matsuyama S, Itoh M, Yokoi K, Taniguchi Y, Yasaka Y, Kawai H. P5782Very long-term outcome of arrhythmogenic right ventricular cardiomyopathy patients with or without an implantable cardioverter defibrillator. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.p5782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- K Imamura
- Himeji Cardiovascular Center, Himeji, Japan
| | - A Shimane
- Himeji Cardiovascular Center, Himeji, Japan
| | | | - M Itoh
- Himeji Cardiovascular Center, Himeji, Japan
| | - K Yokoi
- Himeji Cardiovascular Center, Himeji, Japan
| | | | - Y Yasaka
- Himeji Cardiovascular Center, Himeji, Japan
| | - H Kawai
- Himeji Cardiovascular Center, Himeji, Japan
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Kobayashi T, Kawai H, Nakano O, Abe S, Kamimura H, Sakamaki A, Kamimura K, Tsuchiya A, Takamura M, Yamagiwa S, Terai S. Prognostic value of subcutaneous adipose tissue volume in hepatocellular carcinoma treated with transcatheter intra-arterial therapy. Cancer Manag Res 2018; 10:2231-2239. [PMID: 30100754 PMCID: PMC6065564 DOI: 10.2147/cmar.s167417] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background Prognosis of patients with hepatocellular carcinoma (HCC) who undergo transcatheter intra-arterial therapies, including transcatheter arterial chemoembolization and transcatheter arterial infusion chemotherapy, is affected by many clinical factors including liver function and tumor progression. However, the effect of body composition such as skeletal muscle and visceral and subcutaneous adipose tissues (VAT and SAT, respectively) on the prognosis of these patients remains unclear. We investigated the prognostic value of body composition in HCC patients treated with transcatheter intra-arterial therapies. Patients and methods This study retrospectively evaluated 100 HCC patients treated with transcatheter intra-arterial therapies between 2005 and 2015. Areas of skeletal muscle, VAT, and SAT were measured on computed tomography images at third lumbar vertebra level and normalized by the height squared to calculate the skeletal muscle index, VAT index, and SAT index (SATI). The visceral to subcutaneous adipose tissue area ratio was also calculated. Overall survival (OS) was compared between high- and low-index groups for each body composition. Furthermore, prognostic significance was assessed by univariate and multivariate analyses using Cox proportional hazards models. Results Among the body composition indexes, only SATI could significantly differentiate OS (p=0.012). Multivariate analysis showed that SATI (low- vs. high-SATI: HR, 2.065; 95% CI, 1.187–3.593; p=0.010), serum albumin (<3.5 vs. ≥3.5 g/dL; HR, 2.007; 95% CI, 1.037–3.886; p=0.039), serum alpha-fetoprotein (<20 vs. ≥20 ng/mL; HR, 0.311; 95% CI, 0.179–0.540; p<0.001), and Modified Response Evaluation Criteria in Solid Tumors assessment (complete response+partial response+stable disease vs. progressive disease; HR, 0.392; 95% CI, 0.221–0.696; p=0.001) were indicated as independent prognostic factors for OS. Conclusion High SAT volume is associated with better survival outcomes in HCC patients treated with transcatheter intra-arterial therapies. Elucidation of the mechanisms regulating SAT volume may offer a new therapeutic strategy for these patients.
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Affiliation(s)
- Takamasa Kobayashi
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan,
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan,
| | - Oki Nakano
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan,
| | - Satoshi Abe
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan,
| | - Hiroteru Kamimura
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan,
| | - Akira Sakamaki
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan,
| | - Kenya Kamimura
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan,
| | - Atsunori Tsuchiya
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan,
| | - Masaaki Takamura
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan,
| | - Satoshi Yamagiwa
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan,
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan,
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Kobayashi T, Kawai H, Nakano O, Abe S, Kamimura H, Sakamaki A, Kamimura K, Tsuchiya A, Takamura M, Yamagiwa S, Terai S. Rapidly declining skeletal muscle mass predicts poor prognosis of hepatocellular carcinoma treated with transcatheter intra-arterial therapies. BMC Cancer 2018; 18:756. [PMID: 30041616 PMCID: PMC6056944 DOI: 10.1186/s12885-018-4673-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [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: 12/18/2017] [Accepted: 07/18/2018] [Indexed: 12/17/2022] Open
Abstract
Background The impact of sarcopenia on the prognosis of patients with hepatocellular carcinoma (HCC) who receive transcatheter intra-arterial therapies, including transcatheter arterial chemoembolization and transcatheter arterial infusion chemotherapy, remains unclear. We investigated the prognostic value of skeletal muscle loss (SML) stratified by cutoffs for sarcopenia and rate of change in skeletal muscle mass over 6 months. Methods We retrospectively evaluated 102 patients with HCC treated with transcatheter intra-arterial therapies between 2005 and 2015. Computed tomography images of the third lumbar vertebra (L3) were analyzed to obtain the skeletal muscle area normalized for the height squared, defined as the skeletal muscle index at L3 (L3 SMI), before and 6 months after treatment. Low or high SMI was defined using cutoff values of 42 cm2/m2 in men and 38 cm2/m2 in women. The rate of change in skeletal muscle mass (ΔL3 SMI) over 6 months was calculated. Overall survival (OS) was compared in groups classified by baseline L3 SMI and ΔL3 SMI; prognostic significance was assessed with univariate and multivariate analyses, using Cox proportional hazards models. Results OS did not differ significantly between groups with low (n = 31) and high (n = 71) SMI at baseline (P = 0.172), but OS was significantly poorer in patients with SML (n = 41), defined as ΔL3 SMI < − 4.6% over 6 months than in those without SML (n = 61, P = 0.018). On multivariate analysis, SML (hazard ratio [HR], 1.675; 95% confidence interval [CI], 1.031–2.721; P = 0.037), serum alpha-fetoprotein ≥20 ng/mL (HR, 2.550; 95% CI, 1.440–4.515; P = 0.001), and maximum tumor diameter ≥ 30 mm (HR, 1.925; 95% CI, 1.166–3.179; P = 0.010) were independent predictors of poor OS. Baseline L3 SMI was not significantly associated with OS (HR, 1.405; 95% CI, 0.861–2.293; P = 0.174). Conclusions ΔL3 SMI was an independent prognostic factor in patients with HCC treated with transcatheter intra-arterial therapies. Further study is required to reveal whether prevention of skeletal muscle depletion might be a new therapeutic strategy to contribute to improved clinical outcomes in patients with HCC.
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Affiliation(s)
- Takamasa Kobayashi
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori Chuo-ku, Niigata, 951-8510, Japan
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori Chuo-ku, Niigata, 951-8510, Japan.
| | - Oki Nakano
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori Chuo-ku, Niigata, 951-8510, Japan
| | - Satoshi Abe
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori Chuo-ku, Niigata, 951-8510, Japan
| | - Hiroteru Kamimura
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori Chuo-ku, Niigata, 951-8510, Japan
| | - Akira Sakamaki
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori Chuo-ku, Niigata, 951-8510, Japan
| | - Kenya Kamimura
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori Chuo-ku, Niigata, 951-8510, Japan
| | - Atsunori Tsuchiya
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori Chuo-ku, Niigata, 951-8510, Japan
| | - Masaaki Takamura
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori Chuo-ku, Niigata, 951-8510, Japan
| | - Satoshi Yamagiwa
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori Chuo-ku, Niigata, 951-8510, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori Chuo-ku, Niigata, 951-8510, Japan
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Takahashi K, Hashimoto S, Mizuno KI, Kobayashi T, Tominaga K, Sato H, Kohisa J, Ikarashi S, Hayashi K, Takeuchi M, Yokoyama J, Kawai H, Sato Y, Kobayashi M, Terai S. Management decision based on lymphovascular involvement leads to favorable outcomes after endoscopic treatment of esophageal squamous cell carcinoma. Endoscopy 2018; 50:662-670. [PMID: 29272907 DOI: 10.1055/s-0043-124433] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [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: 12/10/2022]
Abstract
BACKGROUND Esophageal squamous cell carcinoma (ESCC) invading the muscularis mucosae (MM) and submucosa up to 200 µm (SM1) has a risk of metastasis. The aims of this study were to investigate the long-term outcome of endoscopic submucosal dissection (ESD) for MM/SM1 ESCC and to assess the management after ESD in our hospital. METHODS This was a retrospective cohort study conducted at a single institution. Patients with MM or SM1 ESCC who were treated with ESD were included. Additional prophylactic therapy was added if lymphovascular involvement (LVI) was noted in the ESD specimens. RESULTS A total of 102 patients were analyzed. The median length of follow-up was 71.5 months (range 9 - 144 months) and the median number of CTs was 6 (range 0 - 24). LVI was found in 21 patients (20.6 %), and 12 patients underwent additional prophylactic therapy. The 5-year overall survival, disease-specific survival, and tumor-free survival rates were 84.1 %, 97.5 %, and 82.1 %, respectively. A total of 26 patients died, but only 2 of them died from ESCC. The cumulative metastasis rate was 11.8 %, and LVI was a significant predictor of metastasis (hazard ratio 5.42, 95 % confidence interval 1.39 - 21.18; P = 0.02). There were no differences between patients with MM ESCC and those with SM1 ESCC. CONCLUSIONS The long-term outcome after ESD for MM/SM1 ESCC was favorable with additional prophylactic therapy and strict adherence to follow-up. These results indicate that our management decision based on LVI is a valid approach and that ESD can be offered as a therapeutic option to MM/SM1 ESCCs.
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Affiliation(s)
- Kazuya Takahashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Satoru Hashimoto
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Ken-Ichi Mizuno
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Takamasa Kobayashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kentaro Tominaga
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hiroki Sato
- Division of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Niigata, Japan
| | - Junji Kohisa
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Satoshi Ikarashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Kazunao Hayashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Manabu Takeuchi
- Division of Gastroenterology and Hepatology, Nagaoka Red Cross Hospital, Niigata, Japan
| | - Junji Yokoyama
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Yuichi Sato
- Department of Gastroenterology, Niigata Prefectural Yoshida Hospital, Niigata, Japan
| | - Masaaki Kobayashi
- Division of Gastroenterology and Hepatology, Niigata Cancer Center Hospital, Niigata, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Murakami M, Watanabe Y, Edahiro A, Ohara Y, Obuchi S, Kawai H, Kim H, Fujiwara Y, Ihara K, Murakami M, Hirano H. Factors related to dissociation between objective and subjective masticatory function in Japanese community-dwelling elderly adults. J Oral Rehabil 2018; 45:598-604. [PMID: 29761827 DOI: 10.1111/joor.12650] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/09/2018] [Indexed: 11/28/2022]
Abstract
Clinicians' evaluations of older adults sometimes reveal inconsistencies between objective and subjective dental status. This study investigated which factors contribute both to good objective masticatory function (OMF) and the poor subjective masticatory function (SMF) that often becomes a clinical issue. Study participants included 635 elderly community-dwelling Japanese adults who underwent a comprehensive geriatric health examination in 2012. SMF was assessed with a question from the Kihon Checklist on eating difficulties (poor or good). OMF was assessed by a colour-changing gum (poor or good). Also investigated were age, sex, depressive symptoms, instrumental activities of daily living (I-ADLs), number of people who joined the participant at dinner, grip strength, usual walking speed, number of remaining teeth, number of functional teeth and their occlusal force. The group with good OMF and good SMF, defined as group 1, and the group with good OMF but poor SMF, group 2, were compared. Logistic regression analyses confirmed that the number of remaining and functional teeth participants had was statistically unrelated to differences between OMF and SMF. Instead, differences were related to stronger depressive symptoms (OR = 1.67, CI = 1.14-2.44), less ability to conduct I-ADL activities (OR = 0.73, CI = 0.59-0.91), slower usual walking speeds (OR = 0.18, CI = 0.06-0.58) and less occlusal force (OR = 0.99, CI = 0.99-1.00). Depressive symptoms, I-ADLs, and physical function are shown to be significantly related to divergence between objective and subjective masticatory function in elderly Japanese. This suggests that dissociations between objective and subjective dental evaluations of elderly adults indicate need for assessment of their mental and physical function.
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Affiliation(s)
- M Murakami
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Y Watanabe
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - A Edahiro
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Y Ohara
- Tokyo Medical and Dental University, Tokyo, Japan
| | - S Obuchi
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - H Kawai
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - H Kim
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - Y Fujiwara
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
| | - K Ihara
- Toho University, Tokyo, Japan
| | - M Murakami
- International University of Health and Welfare Sanno Hospital, Tokyo, Japan
| | - H Hirano
- Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan
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Seino S, Tsuchiya A, Watanabe Y, Kawata Y, Kojima Y, Ikarashi S, Yanai H, Nakamura K, Kumaki D, Hirano M, Funakoshi K, Aono T, Sakai T, Sakata J, Takamura M, Kawai H, Yamagiwa S, Wakai T, Terai S. Clinical outcome of hepatocellular carcinoma can be predicted by the expression of hepatic progenitor cell markers and serum tumour markers. Oncotarget 2018; 9:21844-21860. [PMID: 29774107 PMCID: PMC5955154 DOI: 10.18632/oncotarget.25074] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 07/11/2017] [Accepted: 03/22/2018] [Indexed: 12/24/2022] Open
Abstract
The high heterogeneity of hepatocellular carcinomas (HCCs) complicates stratification of HCC patients for treatment. Therefore, it is necessary to establish a comprehensive panel of HCC biomarkers related to tumour behaviour and cancer prognosis. Resected HCCs from 251 patients were stained for hepatic progenitor cell (HPC) markers epithelial cell adhesion molecule (EpCAM), neural cell adhesion molecule (NCAM), delta-like 1 homolog (DLK1), and cytokeratin 19 (CK19). Staining patterns were analysed for their prognostic association with relapse-free survival and overall survival. α-Fetoprotein (AFP), lectin-reactive α-fetoprotein (AFP-L3), and des-γ-carboxy prothrombin (DCP) were assessed as indicators of HPC protein expression. Expression pattern of HPC markers correlated with tumour malignancy indicated by high AFP/AFP-L3 serum levels, more frequent vascular invasion, and poorer tumour differentiation. EpCAM expression, DCP ≥300 mAU/ml, age ≥60, and Child-Pugh score grade B or C were independent prognostic factors of poor outcome and were used in a new scoring system for HCC prognosis after operation. Expression of two or more HPC markers was a significant predictor of poor HCC outcome and serum levels of AFP/AFP-L3 correlated with the expression of HPC proteins. Our study paved the way for further elucidation of the association among HPC markers, serum tumour markers, and HCC clinical outcome for precision medicine.
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Affiliation(s)
- Satoshi Seino
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Atsunori Tsuchiya
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Yusuke Watanabe
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Yuzo Kawata
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Yuichi Kojima
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Shunzo Ikarashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Hiroyuki Yanai
- Drug Discovery Laboratories, Chiome Bioscience Inc., 907 Nogawa, Miyamae-Ku, Kawasaki-Shi, Kanagawa 216-0001, Japan
| | - Koji Nakamura
- Drug Discovery Laboratories, Chiome Bioscience Inc., 907 Nogawa, Miyamae-Ku, Kawasaki-Shi, Kanagawa 216-0001, Japan
| | - Daisuke Kumaki
- Division of Gastroenterology and Hepatology, Niigata Prefectural Central Hospital, Joetsu-Shi, Niigata 943-0147, Japan
| | - Masaaki Hirano
- Division of Gastroenterology and Hepatology, Niigata Prefectural Central Hospital, Joetsu-Shi, Niigata 943-0147, Japan
| | - Kazuhiro Funakoshi
- Division of Gastroenterology and Hepatology, Niigata Prefectural Central Hospital, Joetsu-Shi, Niigata 943-0147, Japan
| | - Takashi Aono
- Division of Surgery, Niigata Prefectural Central Hospital, Joetsu-Shi, Niigata 943-0147, Japan
| | - Takeshi Sakai
- Division of Diagnostic Pathology, Niigata Prefectural Central Hospital, Joetsu-Shi, Niigata 943-0147, Japan
| | - Jun Sakata
- Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Masaaki Takamura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Satoshi Yamagiwa
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Toshifumi Wakai
- Division of Digestive and General Surgery, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Chuo-Ku, Niigata 951-8510, Japan
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44
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Kamimura H, Yamagiwa S, Tomohiro I, Higuchi W, Ogata N, Tsuchiya A, Kamimura K, Takamura M, Kawai H, Terai S. Bleeding from a Small-Intestinal Ulcer Associated with Chronic Hepatitis C. Am J Case Rep 2018; 19:234-237. [PMID: 29500336 PMCID: PMC5844191 DOI: 10.12659/ajcr.908594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Hepatitis C virus infection is probably the most common chronic viral infection and affects an estimated 180 million people worldwide. Extrahepatic manifestations are well recognized among patients with chronic HCV infection. CASE REPORT We report a case of melena occurring in a 69-year-old Japanese man who had been diagnosed with CHC and who was treated with antiviral therapy. CONCLUSIONS Finally, he was diagnosed with multiple small intestine ulcers in a short time. We herein report the case of HCV with rapidly developing small intestine ulcers.
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Affiliation(s)
- Hiroteru Kamimura
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan
| | - Satoshi Yamagiwa
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan
| | - Iwasaki Tomohiro
- Department of Internal Medicine, Japan Labor Health and Welfare Organization Tsubame Rosai Hospital, Tsubame, Niigata, Japan
| | - Wataru Higuchi
- Department of Internal Medicine, Japan Labor Health and Welfare Organization Tsubame Rosai Hospital, Tsubame, Niigata, Japan
| | - Norio Ogata
- Department of Internal Medicine, Japan Labor Health and Welfare Organization Tsubame Rosai Hospital, Tsubame, Niigata, Japan
| | - Atsunori Tsuchiya
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan
| | - Kenya Kamimura
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan
| | - Masaaki Takamura
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata City, Niigata, Japan
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Matsuda Y, Masuda M, Asai M, Iida O, Okamoto S, Ishihara T, Nanto K, Kanda T, Tsujimura T, Okuno S, Ohashi T, Kawai H, Tsuji A, Hata Y, Mano T. P1201The association with p-wave duration and the prevalence of left atrial low-voltage areas. Europace 2018. [DOI: 10.1093/europace/euy015.683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Y Matsuda
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - M Masuda
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - M Asai
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - O Iida
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - S Okamoto
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - T Ishihara
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - K Nanto
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - T Kanda
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - T Tsujimura
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - S Okuno
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - T Ohashi
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - H Kawai
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - A Tsuji
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - Y Hata
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - T Mano
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
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46
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Matsuda Y, Masuda M, Asai M, Iida O, Okamoto S, Ishihara T, Nanto K, Kanda T, Tsujimura T, Okuno S, Ohashi T, Kawai H, Tsuji A, Hata Y, Mano T. P1169Severity of chronic kidney disease predicts the prevalence of left atrial low-voltage areas. Europace 2018. [DOI: 10.1093/europace/euy015.654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Y Matsuda
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - M Masuda
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - M Asai
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - O Iida
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - S Okamoto
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - T Ishihara
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - K Nanto
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - T Kanda
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - T Tsujimura
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - S Okuno
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - T Ohashi
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - H Kawai
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - A Tsuji
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - Y Hata
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
| | - T Mano
- Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan
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47
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Motokawa K, Watanabe Y, Edahiro A, Shirobe M, Murakami M, Kera T, Kawai H, Obuchi S, Fujiwara Y, Ihara K, Tanaka Y, Hirano H. Frailty Severity and Dietary Variety in Japanese Older Persons: A Cross-Sectional Study. J Nutr Health Aging 2018; 22:451-456. [PMID: 29484361 DOI: 10.1007/s12603-018-1000-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [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: 10/18/2022]
Abstract
Providing older person individuals with an appropriate intervention at the time of frailty onset is important to prevent the progression of the condition and the need for long-term care. However, the proper timing of starting nutritional and dietary interventions for frail older person subjects has not been fully elucidated. Therefore, in this cross-sectional study, we aimed to clarify the association between frailty and dietary variety among older persons in Japan. We surveyed sex, age, body height, body weight, body mass index, serum albumin level, dietary variety, and nutritional intake indexes in 747 community-dwelling older person individuals who underwent a comprehensive health examination in October 2014. Frailty was determined using the Kihon Checklist (25 questions). Kihon Checklist is widely used to assess frailty in Japan, and their physical, cognitive and social function was evaluated. After excluding those who did not complete the Kihon Checklist and those who required long-term care, frailty status was analyzed in 665 older person individuals. The numbers and percentages of frail, pre-frail and robust older persons were found to be 77 (11.6%), 182 (27.4%) and 406 (61.0%) respectively. Significant differences among robust, pre-frail, and frail subjects were observed in terms of age, serum albumin level, alcohol consumption, smoking, and history of diabetes. Among the nutrition-related indexes, only the dietary variety showed a significant difference. The results of ordinal logistic regression analysis showed a significant association between frailty and sex, age, smoking status, diabetes, and dietary variety score. Dietary variety was significantly associated with the progression of frailty among older persons in the community.
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Affiliation(s)
- K Motokawa
- Yutaka Watanabe, Tokyo Metropolitan Institute of Gerontology, Japa, E-Mail:
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Kamimura K, Shinagawa-Kobayashi Y, Goto R, Ogawa K, Yokoo T, Sakamaki A, Abe S, Kamimura H, Suda T, Baba H, Tanaka T, Nozawa Y, Koyama N, Takamura M, Kawai H, Yamagiwa S, Aoyagi Y, Terai S. Effective prevention of sorafenib-induced hand-foot syndrome by dried-bonito broth. Cancer Manag Res 2018; 10:805-813. [PMID: 29713197 PMCID: PMC5911389 DOI: 10.2147/cmar.s159370] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Sorafenib (SOR) is a molecular medicine that prolongs the survival of patients with hepatocellular carcinoma (HCC). Therefore, the management of side effects is essential for the longer period of continuous medication. Among the various side effects, hand-foot syndrome (HFS) is the most common, occurring in 30%-50% of patients, and often results in discontinuation of the SOR medication. However, its mechanism has not been clarified, and no effective prevention method has been reported for the symptoms. Therefore, this study aimed to analyze its mechanism and to develop an effective prevention regimen for the symptoms. MATERIALS AND METHODS To assess the mechanism of SOR-induced HFS, the peripheral blood flow in the hand and foot was carefully monitored by Doppler ultrasound, thermography, and laser speckle flowgraphy in the cases treated with SOR and its contribution was assessed. Then, the effect of dried-bonito broth (DBB), which was reported to improve peripheral blood flow, on the prevention of the symptom was examined by monitoring its occurrence and the peripheral blood flow. RESULTS A total of 25 patients were enrolled in this study. In all, eight patients developed HFS, and all cases showed a significant decrease in the peripheral blood flow. DBB contributed to an increase in the flow (p = 0.009) and significantly decreased occurrence of HFS (p = 0.005) than control. Multivariable analysis showed that the ingestion of DBB is a significant independent contributor to HFS-free survival period (p = 0.035). CONCLUSION The mechanism of SOR-induced HFS involves a decrease in the peripheral blood flow, and the ingestion of DBB effectively prevents the development of the syndrome by maintaining the flow.
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Affiliation(s)
- Kenya Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
- Correspondence: Kenya Kamimura, Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1–757 Asahimachi-dori, Chuo-ku, Niigata, Niigata 9518510, Japan, Tel +81 25 227 2207, Fax +81 25 227 0776, Email
| | - Yoko Shinagawa-Kobayashi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Ryo Goto
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Kohei Ogawa
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Takeshi Yokoo
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Akira Sakamaki
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Satoshi Abe
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Hiroteru Kamimura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Takeshi Suda
- Department of Gastroenterology and Hepatology, Uonuma Institute of Community Medicine, Niigata Medical and Dental Hospital, Minami-Uonuma, Niigata, Japan
| | - Hiroshi Baba
- Division of Anesthesiology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | | | - Yoshizu Nozawa
- Institute of Food Sciences and Technologies, Ajinomoto Co., Inc., Kawasaki, Kanagawa, Japan
| | - Naoto Koyama
- Institute for Innovation, Ajinomoto Co., Inc., Kawasaki, Kanagawa, Japan
| | - Masaaki Takamura
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Hirokazu Kawai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Satoshi Yamagiwa
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Yutaka Aoyagi
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
| | - Shuji Terai
- Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Niigata, Japan
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49
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Kobayashi A, Yusaku E, Ito H, Kawai H, Mizuno T, Kento F, Kimura S. Development of High Resolution Gamma-Detectors for PET. EPJ Web Conf 2018. [DOI: 10.1051/epjconf/201817009003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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50
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Adachi K, Hashiguchi S, Saito M, Kashiwagi S, Miyazaki T, Kawai H, Yamada H, Iwase T, Akaike M, Takao S, Kobayashi M, Ishizaki M, Matsumura T, Mori-Yoshimura M, Kimura E. Case series study of detection and management of cardiomyopathy in female dystrophinopathy carriers; A 22-year annual healthcare checkup for mothers of dystrophinopathy patients. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.754] [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: 11/27/2022]
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