1
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Go S, Tsuzuki Y, Yoneda H, Ichikawa Y, Ikeda T, Imai N, Imamura K, Niikura M, Nishimura D, Mizuno R, Takeda S, Ueno H, Watanabe S, Saito TY, Shimoura S, Sugawara S, Takamine A, Takahashi T. Demonstration of nuclear gamma-ray polarimetry based on a multi-layer CdTe Compton camera. Sci Rep 2024; 14:2573. [PMID: 38336981 DOI: 10.1038/s41598-024-52692-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 01/22/2024] [Indexed: 02/12/2024] Open
Abstract
To detect and track structural changes in atomic nuclei, the systematic study of nuclear levels with firm spin-parity assignments is important. While linear polarization measurements have been applied to determine the electromagnetic character of gamma-ray transitions, the applicable range is strongly limited due to the low efficiency of the detection system. The multi-layer Cadmium-Telluride (CdTe) Compton camera can be a state-of-the-art gamma-ray polarimeter for nuclear spectroscopy with the high position sensitivity and the detection efficiency. We demonstrated the capability to operate this detector as a reliable gamma-ray polarimeter by using polarized 847-keV gamma rays produced by the [Formula: see text]([Formula: see text]) reaction. By combining the experimental data and simulated calculations, the modulation curve for the gamma ray was successfully obtained. A remarkably high polarization sensitivity was achieved, compatible with a reasonable detection efficiency. Based on the obtained results, a possible future gamma-ray polarimetery is discussed.
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Affiliation(s)
- S Go
- RIKEN Cluster for Pioneering Research, RIKEN, Wako, Saitama, Japan.
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, Wako, Saitama, Japan.
| | - Y Tsuzuki
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, Wako, Saitama, Japan
- Department of Physics, The University of Tokyo, Tokyo, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo, Chiba, Japan
| | - H Yoneda
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, Wako, Saitama, Japan
- Lehrstuhl für Astronomie, Fakultät für Physik und Astronomie, Institut für Theoretische Physik und Astrophysik, Julius-Maximilians-Universität Würzburg, Emil-Fischer-Str. 31, 97074, Würzburg, Germany
| | - Y Ichikawa
- Department of Physics, Kyushu University, Fukuoka, Japan
| | - T Ikeda
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, Wako, Saitama, Japan
| | - N Imai
- Center for Nuclear Study, The University of Tokyo, Wako, Saitama, Japan
| | - K Imamura
- RIKEN Cluster for Pioneering Research, RIKEN, Wako, Saitama, Japan
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, Wako, Saitama, Japan
| | - M Niikura
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, Wako, Saitama, Japan
| | - D Nishimura
- Department of Natural Sciences, Tokyo City University, Tokyo, Japan
| | - R Mizuno
- Department of Physics, The University of Tokyo, Tokyo, Japan
| | - S Takeda
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo, Chiba, Japan
| | - H Ueno
- RIKEN Cluster for Pioneering Research, RIKEN, Wako, Saitama, Japan
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, Wako, Saitama, Japan
| | - S Watanabe
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, Kanagawa, Japan
| | - T Y Saito
- Center for Nuclear Study, The University of Tokyo, Wako, Saitama, Japan
- Atomic, Molecular, and Optical Physics Laboratory, RIKEN, Wako, Saitama, Japan
| | - S Shimoura
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, Wako, Saitama, Japan
- Center for Nuclear Study, The University of Tokyo, Wako, Saitama, Japan
| | - S Sugawara
- Department of Natural Sciences, Tokyo City University, Tokyo, Japan
| | - A Takamine
- RIKEN Cluster for Pioneering Research, RIKEN, Wako, Saitama, Japan
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, Wako, Saitama, Japan
| | - T Takahashi
- Department of Physics, The University of Tokyo, Tokyo, Japan
- Kavli Institute for the Physics and Mathematics of the Universe (WPI), The University of Tokyo, Chiba, Japan
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2
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Nagata K, Takiyama H, Tashiro K, Yamadera M, Okamoto K, Kajiwara Y, Shinto E, Kishi Y, Matsukuma S, Yamada S, Ueno H. Multidisciplinary management of locally recurrent rectal cancer with carbon ion radiotherapy followed by prophylactic removal of the irradiated bowel: a case report. Surg Case Rep 2024; 10:13. [PMID: 38196031 PMCID: PMC10776531 DOI: 10.1186/s40792-024-01811-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 01/04/2024] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Locally recurrent rectal cancer (LRRC) involving the upper sacrum is typically incurable, and palliative treatment is the only option for most patients, resulting in a poor prognosis and reduced quality of life. Carbon ion radiotherapy (CIRT) has emerged as a promising modality for treating LRRC. This report presents a case of LRRC with sacral involvement that was managed via multidisciplinary therapy incorporating CIRT. CASE PRESENTATION A 55-year-old male was diagnosed with an anastomotic recurrence of rectal cancer 15 months after undergoing anterior resection. Computed tomography (CT) suggested that the lesion was at an anastomosis site and broadly adherent to the upper sacrum, and colonoscopy confirmed the diagnosis of LRRC. Histopathological examination of the biopsy specimens revealed adenocarcinoma cells and that lesion was genetically RAS-wild. Induction chemotherapy with mFOLFOX6 and panitumumab was used as the first treatment. The recurrent lesion shrank and no signs of distant metastasis were observed after 11 cycles, although the range of the lesions attached to the sacrum remained unchanged. Therefore, we provided CIRT for this inoperable lesion and prophylactically removed the radiation-exposed bowel including the recurrent lesion, because radiation-induced ulcers can cause bleeding and perforation. Despite the presence of considerable fibrosis in the irradiated region, the operation was successful and the postoperative course had no untoward incidents. He is still recurrence-free 24 months following surgery, despite the lack of adjuvant chemotherapy. This is the first report of CIRT followed by CIRT-irradiated bowel removal for an unresectable anastomosis recurrent lesion. CONCLUSIONS The clinical course of this case suggests that CIRT could be a potentially effective therapeutic option for LRRC involving the bowel, as long as the prophylactic removal of the irradiated bowel is performed at the optimal time. Further research involving larger sample sizes is warranted to validate the findings and conclusions of this case report.
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Affiliation(s)
- K Nagata
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
| | - H Takiyama
- QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - K Tashiro
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - M Yamadera
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - K Okamoto
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Y Kajiwara
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - E Shinto
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - Y Kishi
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - S Matsukuma
- Department of Pathology and Laboratory Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
| | - S Yamada
- QST Hospital, National Institutes for Quantum Science and Technology, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555, Japan
| | - H Ueno
- Department of Surgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan
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3
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Ahn DS, Amano J, Baba H, Fukuda N, Geissel H, Inabe N, Ishikawa S, Iwasa N, Komatsubara T, Kubo T, Kusaka K, Morrissey DJ, Nakamura T, Ohtake M, Otsu H, Sakakibara T, Sato H, Sherrill BM, Shimizu Y, Sumikama T, Suzuki H, Takeda H, Tarasov OB, Ueno H, Yanagisawa Y, Yoshida K. Discovery of ^{39}Na. Phys Rev Lett 2022; 129:212502. [PMID: 36461972 DOI: 10.1103/physrevlett.129.212502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 09/08/2022] [Accepted: 09/14/2022] [Indexed: 06/17/2023]
Abstract
The new isotope ^{39}Na, the most neutron-rich sodium nucleus observed so far, was discovered at the RIKEN Nishina Center Radioactive Isotope Beam Factory using the projectile fragmentation of an intense ^{48}Ca beam at 345 MeV/nucleon on a beryllium target. Projectile fragments were separated and identified in flight with the large-acceptance two-stage separator BigRIPS. Nine ^{39}Na events have been unambiguously observed in this work and clearly establish the particle stability of ^{39}Na. Furthermore, the lack of observation of ^{35,36}Ne isotopes in this experiment significantly improves the overall confidence that ^{34}Ne is the neutron dripline nucleus of neon. These results provide new key information to understand nuclear binding and nuclear structure under extremely neutron-rich conditions. The newly established stability of ^{39}Na has a significant impact on nuclear models and theories predicting the neutron dripline and also provides a key to understanding the nuclear shell property of ^{39}Na at the neutron number N=28, which is normally a magic number.
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Affiliation(s)
- D S Ahn
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - J Amano
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - H Baba
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - N Fukuda
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Geissel
- GSI, Helmholtzzentrum für Schwerionenforschung GmbH, Planckstraße 1, 64291 Darmstadt, Germany
| | - N Inabe
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - S Ishikawa
- Department of Physics, Tohoku University, 6-3, Aramaki Aza-Aoba, Aoba-ku, Sendai, Miyagi 980-8578, Japan
| | - N Iwasa
- Department of Physics, Tohoku University, 6-3, Aramaki Aza-Aoba, Aoba-ku, Sendai, Miyagi 980-8578, Japan
| | - T Komatsubara
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Kubo
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Kusaka
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D J Morrissey
- National Superconducting Cyclotron Laboratory, Michigan State University, 640 South Shaw Lane, East Lansing, Michigan 48824, USA
| | - T Nakamura
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - M Ohtake
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Otsu
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Sakakibara
- Department of Physics, Tohoku University, 6-3, Aramaki Aza-Aoba, Aoba-ku, Sendai, Miyagi 980-8578, Japan
| | - H Sato
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - B M Sherrill
- National Superconducting Cyclotron Laboratory, Michigan State University, 640 South Shaw Lane, East Lansing, Michigan 48824, USA
| | - Y Shimizu
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Sumikama
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Suzuki
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Takeda
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - O B Tarasov
- National Superconducting Cyclotron Laboratory, Michigan State University, 640 South Shaw Lane, East Lansing, Michigan 48824, USA
| | - H Ueno
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Y Yanagisawa
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Yoshida
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
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4
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Hada M, Hoshino M, Sugiyama T, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. the diagnostic value of left-anterior-descending artery velocity assessed by transthoracic Doppler echocardiography for microvascular dysfunction in stenotic left-anterior-descending artery. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.167] [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
Index of microcirculatory resistance (IMR) has been used as a clinical measure of microvascular function. Transthoracic Doppler echocardiography (TDE) can provide information on the functional status of coronary artery circulation. This study aims to assess the diagnostic value of left-anterior-descending artery (LAD) flow velocity by TDE for microvascular dysfunction.
Methods
Consecutive patients who were scheduled for elective percutaneous coronary intervention (PCI) for LAD lesions were prospectively enrolled in the single tertiary-care center between April 2020 and July 2021. Pre-PCI LAD diastolic peak velocity (DPV) by TDE at rest and hyperemia were measured. By invasive coronary angiography, quantitative coronary angiography and invasive wire-based physiological indices including fractional flow reserve (FFR) and index of microcirculatory resistance (IMR) were measured.
Results
A total of 104 patients were studied. Median FFR and IMR values were 0.70 (0.60–0.74) and 20.68 (14.92–31.69), respectively. No significant relationship was observed between FFR and IMR. The prevalence of microvascular dysfunction defined as IMR≥25 was 39.4%. Basal DPV was 25 (20–33) cm/sec, and hyperemic DPV was 51 (41–67) cm/sec. In lesions with IMR≥25, reference diameter (RD) was significantly greater [2.63 (2.22–3.19) mm vs 2.39 (2.09–2.66) mm, p=0.019], basal DPV was lower [26 (18–29) cm/sec vs 29 (22–37) cm/sec, p=0.022)] and hyperemic DPV was lower [49 (19–54) cm/sec vs 56 (42–70) cm/sec, p=0.023] compared to lesions with IMR<25. ROC analysis showed basal DPV and RD are significant predictors of IMR≥25 [basal DPV: AUC 0.633 (0.525–0.742), best cutoff 29cm/sec RD: AUC 0.636 (0.523–0.750), best cutoff 2.84mm]. Multivariable logistic regression analysis showed basal DPV<29cm/sec and RD>2.84mm are independent predictors for IMR≥25 [Odds ratio: 3.08 (1.22–7.78), p=0.017; odds ratio 4.40 (1.55–12.50), p=0.005].
Conclusion
Basal DPV by non-invasive pre-PCI TDE and reference diameter can predict lesions with coexisting microvascular dysfunction in LAD territory with functionally significant lesions without the need of vasodilator-induced hyperemia and a wire-based invasive physiological measurement.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Hada
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
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5
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Nogami K, Hoshino M, Kanaji Y, Sugiyama T, Misawa T, Hada M, Yamaguchi M, Nagamine T, Teng Y, Ueno H, Matsuda K, Sayama K, Kakuta T. Prognostic implications of unrecognized myocardial infarction before elective percutaneous coronary intervention. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.292] [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
A non-negligible proportion of myocardial infarction (MI) is not clinically recognized and unrecognized myocardial infarction (UMI) is associated with adverse outcomes.
Purpose
To determine the prevalence and prognostic significance of UMI by delayed-enhancement cardiac magnetic resonance (DE-CMR) before elective percutaneous coronary intervention (PCI).
Methods
In this prospective, single-center study, 236 patients with stable coronary artery disease undergoing elective and uncomplicated PCI were studied. All patients underwent DE-CMR before PCI. The prevalence of UMI was evaluated and the association of clinical and CMR-derived variables with primary MACE, defined as cardiovascular death, nonfatal MI, hospitalization for heart failure, unplanned late revascularization, and ischemic stroke was investigated.
Results
In the final analysis of 213 patients, 63 patients (29.6%) showed UMI. Target territory UMI was observed in 38 (17.8% of total, 60.3% of patients with UMI). UMI was significantly associated with sex, diabetes mellitus, left ventricular ejection fraction, SYNTAX score and fractional flow reserve in target vessels. During follow-up periods (median, 23 months), MACE was observed in 17 (27.0%) of patients with UMI, and 17 (11.3%) without (P=0.001). In a multivariable model, UMI (hazard ratio [HR] 2.18, 95% confidential interval, 1.10–4.33, P=0.001) remained as an independent predictor of MACE. Kaplan–Meier analysis indicated that the presence of UMI was significantly associated with higher incidence of MACE.
Conclusions
The prevalence of UMI in patients undergoing elective PCI was 29.6%. UMI was independently associated with an increased risk of MACE after successful PCI. Given the non-negligible prevalence and potential clinical significance of UMI, clinical studies comparing PCI and guideline directed medical therapy (GDMT) versus GDMT only strategy might have to take the presence of UMI into consideration.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Nogami
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Teng
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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6
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Sayama K, Hoshino M, Kanaji Y, Sugiyama T, Misawa T, Hada M, Nagamine T, Nogami K, Teng Y, Ueno H, Matsuda K, Yonetsu T, Kakuta T. Prognostic implication of unrecognized myocardial infarction in patients with non-ST-segment-elevation acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.287] [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
Prognostic value of unrecognized non-infarct-related territory (non-IR) myocardial infarction (UMI) in patients with non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) remains to be elucidated.
Purpose
This study sought to evaluate the prevalence of non-IR UMI and its prognostic value in patients with first NSTE-ACS presentation.
Methods
This retrospective single-center analysis was conducted in patients with NSTE-ACS without prior history of coronary artery disease, who underwent uncomplicated urgent percutaneous coronary intervention (PCI) within 48 hours of admission between August 2014 and January 2018. All patients underwent postprocedural cardiac magnetic resonance imaging (CMR) within 30 days after PCI. Non-IR UMI was defined as the presence of non-IR delayed gadolinium enhancement with an ischemic distribution pattern. We investigated the association of non-IR UMI, other CMR findings and baseline clinical characteristics with major adverse cardiac events (MACE), defined as all-cause death, non-fatal myocardial infarction, ischemic stroke, late revascularization and hospitalization for congestive heart failure.
Results
A total of 168 NSTE-ACS patients were included (124 males (73.8%); 66±11 years). Non-IR UMI was detected in 28 patients (16.7%). During a median follow-up of 32 months (15–58), MACE occurred in 10 (35.7%) patients with non-IR UMI, and 20 (14.3%) patients without (P=0.013). Patients with MACE showed higher frequency of non-IR UMI in RCA territory and multi vessel disease, higher level of NT-proBNP at admission, higher Genisini score, and greater extent of UMI. Cox's proportional hazards analysis showed that the presence of non-IR UMI was an independent predictor of MACE (HR 2.34, 95% CI 1.02–5.37, P=0.045), after adjusting confounding factors, such as multi vessel disease and serum levels of NT-proBNP at admission. The discriminant efficacy (IDI and NRI) of predicting MACE was significantly improved when the presence of non-IR UMI added to the reference clinical risk model. Kaplan-Meier analysis revealed that patients with non-IR UMI were significantly associated with poor prognosis. (Figure 1).
Conclusions
In patients with NSTE-ACS undergoing urgent PCI, the prevalence of non-IR UMI was 16.7%. Non-IR UMI provided prognostic information independent of conventional risk factors.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Teng
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Division of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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7
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Nagamine T, Hoshino M, Matsuda K, Misawa T, Sugiyama T, Sasano T, Sayama S, Ueno H, Hada M, Yonetsu T, Kakuta T. Identification of coronary plaque rupture or erosion by preprocedural computed tomography angiography in patients with non-st-segment elevation acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1182] [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 frequent pathological cause of acute coronary thrombosis is plaque rupture or erosion. A previous CT angiographic study failed to discriminate OCT-defined intact fibrous cap culprit lesions (IFC lesions) from those with ruptured fibrous cap (RFC group) in patients with acute coronary syndrome (ACS) and chronic coronary syndrome.
Objectives
This study aimed to evaluate the diagnostic efficacy of preprocedural coronary CT imaging to identify optical coherence tomography (OCT)-defined plaque rupture or erosion at culprit lesions in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).
Methods
Consecutive patients with suspected NSTE-ACS who underwent preprocedural non-contrast CT and CT angiography (CCTA) were studied. Patients with at least one lesion with more than 50% stenosis at the proximal segment on CCTA were subsequently assessed by invasive coronary angiography and OCT. ALL CT and OCT examination were performed within 24 hours from presentation. The diagnosis of intact fibrous cap or ruptured fibrous cap was made by OCT for the angiographically most severely stenosed lesion. Cases of ambiguous OCT diagnosis such as massive thrombosis or calcified nodule precluding the fibrous cap assessment were excluded from the final analysis.
Results
In the final analysis of 176 patients, OCT identified 87 RFC plaques and 89 IFC plaques for the culprit lesions, respectively. In IFC group, lower prevalence of diabetes mellitus (24.7% vs. 41.4%, P=0.025) and lower peak cardiac marker elevation (CPK, 159 vs. 272 U/L, P<0.001) were observed. On CT, the prevalence of low attenuation plaque, positive remodeling, napkin ring sign, spotty calcification, calcium score (CAC), and culprit vessel pericoronary adipose tissue attenuation (FAI) were all significantly low in IFC group. Multivariate regression analysis to predict IFC at culprit lesions revealed that the absence of low attenuation plaque, the absence of napkin ring sign, zero CAC, and low FAI were independent predictors of IFC. When stratified by the number of these 4 CT factors, the presence of IFC were stratified as 0%, 23.6%, 50%, 77.8%, and 100% (P<0.001), respectively. Adding non-contrast CT factor of zero CAC to the reference model including age, sex, DM, EF, low attenuation plaque, napkin ring sign, and FAI, can increase the incremental discriminatory and reclassification performance for the prediction of IFC (C-statistic 0.828 NRI: 0.37, 95% CI: 0.095–0.646, P=0.008 and IDI: 0.042, 95% CI: 0.012–0.071, P=0.005).
Conclusions
Preprocedural comprehensive CT imaging including CAC and pericoronary adipose tissue inflammation could identify IFC or RFC culprit lesions defined by OCT. Further studies are needed to confirm our preliminary results and if CT imaging in NSTE-ACS provides prognostic information or specific therapeutic approach such as conservative therapy or non-stenting strategy before invasive angiography.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - S Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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8
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Hada M, Hoshino M, Sugiyama T, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. Diagnostic value of computed tomography myocardial perfusion to detect coexisting microvascular dysfunction in patients with obstructive epicardial coronary disease. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.217] [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 usefulness of computed tomography myocardial perfusion (CTP) to assess hemodynamically significant epicardial coronary artery lesions has been previously reported. However, the diagnostic value of quantitative evaluation of absolute coronary flow by CTP to detect microvascular dysfunction remains unknown.
Purpose
The aim of study is to assess the diagnostic value of CTP to evaluate coronary microvascular dysfunction (CMD) in patients with significant epicardial coronary stenosis, and to analyze the predicting factors for lesions with CMD.
Methods
Sixty-eight chronic coronary syndrome patients with de novo single functionally significant stenosis (Fractional flow reserve [FFR] <0.80) were investigated. CMD was defined by the index of microcirculatory resistance (IMR) ≥25. Clinical characteristics and CTP findings were compared between the two groups with and without CMD (CMD, n=29, non-CMD, n=39, respectively). The computed tomography angiography (CCTA) assessment included CTP findings and quantitative and qualitative assessment of plaques.
Results
In wire-based analysis, FFR, coronary flow reserve (CFRwire) and IMR were 0.68 (0.59–0.74), 1.71 (1.24–2.88), and 22.6 (15.1–34.5), respectively.
In CTP analysis, culprit territory regional absolute myocardial blood flow (MBF) at rest (rest-MBF) and hyperemia (hyperemic-MBF) were evaluated semi-automatically. CTP-derived CFR (CFRCTP) was calculated as hyperemic-MBF divided by rest-MBF. Rest and hyperemic-MBF and CFRCTP were 0.83 (0.64–1.03) ml/min/g, 2.14 (1.30–2.92) ml/min/g, and 2.19 (1.44–3.37).
In the lesions with CMD, hyperemic-MBF was significantly lower than those without CMD (1.68 [0.84–2.44] vs 2.31 [1.67–3.34] ml/min/g, p=0.015) and the prevalence of CFRCTP<2.0 was higher in the lesions with CMD than those without CMD (62.1% vs 28.2%, p=0.007).
CCTA analysis showed that fibrofatty and necrotic core component (FFNC) volume was greater in the lesions with CMD than in the lesions without CMD (31.8 [19.0–48.9] vs 25.1 [17.2–32.1] mm3, p=0.045). The multivariable logistic regression analysis, hyperemic-MBF and FFNC volume were independent predictors for lesions with CMD (Odds ratio [OR] 0.583 [0.355–0.958], p=0.033 and OR 1.040 [1.010–1.070], p=0.018).
Conclusion
Quantitative assessment of absolute coronary flow by CTP and comprehensive plaque analysis by CCTA may help detect coexisting subtended microvascular dysfunction in patients with functionally significant epicardial coronary lesions. Further studies are needed to elucidate the clinical significance of coexisting CMD in CCS patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Hada
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine , Tsuchiura , Japan
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9
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Hoshino M, Sugiyama T, Kanaji Y, Hada M, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. Multimodality coronary imaging to predict non-culprit territory unrecognized myocardial infarction assessed by cardiac magnetic resonance in non-ST-elevation acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.349] [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
Objectives
This study sought to assess the predictors of coherence tomography (OCT) and coronary computed tomography angiographic (CCTA) findings for non-infarct-related (non-IR) territory unrecognized myocardial infarction (UMI) in patients with first non-ST-elevation acute coronary syndrome (NSTE-ACS) presentation.
Background
UMI detected by cardiac magnetic resonance (CMR) is associated with adverse outcomes in patients with both acute coronary syndrome and chronic coronary syndrome. However, the association between the presence of UMI and findings of multimodality coronary imaging remains unknown.
Methods
We investigated 69 patients with a first clinical episode of NSTE-ACS, who underwent pre-PCI 320-slice CCTA, uncomplicated urgent percutaneous coronary intervention (PCI) with OCT assessment within 48 hours of admission, and post-PCI CMR. UMI was assessed on late gadolinium enhancement (LGE-CMR) by identifying regions of hyperenhancement with an ischemic distribution pattern in non-IR territories (non-IR UMI).
Results
Non-IR UMI was detected in 11 patients (15.9%). ROC analysis revealed the optimal cut-off value of PCATA in culprit vessel for predicting the presence of non-IR UMI were −71.3. Lower ejection fraction, higher Gensini score, high pericoronary inflammation (>−71.3), OCT-defined culprit lesion plaque rupture (OCT-PR), and OCT-defined culprit lesion cholesterol crystal (OCT-CC) were significantly associated with the presence of non-IR UMI (Figure 1A). OCT findings are shown in Figure 1B. Patients with non-IR UMI had a higher prevalence of OCT-PR and OCT-CC than those without. Compared with patients without non-IR UMI, the prevalence of high pericoronary inflammation was higher in patients with non-IR UMI (Figure 1C). When the total cohort was divided into four groups according to the numbers of aforementioned OCT-derived risk factors and PCATA, patients with all of these UMI risk factors showed 46.2% (6/13) prevalence of non-IR UMI, whereas none of 15 patients without these factors showed non-IR UMI (Figure 1D).
Conclusions
When culprit lesion showed OCT-PR, OCT-CC, and high PCATA, about half of these patients are likely to have non-IR UMI. The integrated CCTA and OCT assessment may help identify the presence of non-IR UMI, potentially providing prognostic information in first NSTE-ACS patients.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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10
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Ueno H, Hoshino M, Sugiyama T, Kanaji Y, Hada M, Misawa T, Nagamine T, Nogami K, Sayama K, Matsuda K, Yonetsu T, Sasano T, Kakuta T. Prognostic implications of fractional flow reserve and coronary flow reserve after newer-generation drug-eluting stent implantation. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1212] [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
FFR after percutaneous coronary intervention (PCI) has been reported to provide prognostic information. However, limited data are available regarding the prognostication by CFR in patients treated with elective PCI using newer generation DES.
Purpose
This study aimed to assess the prognostic value of post-procedural fractional flow reserve (FFR) and coronary flow reserve (CFR) after newer-generation drug-eluting stent implantation (DES).
Methods
A total of 466 stenoses in 466 patients underwent FFR-guided PCI. FFR and CFR measurements before and after PCI by a pressure-temperature sensor-tipped wire were performed. Follow-up data were studied to determine the predictors of target vessel failure (TVF), defined as death, target vessel-related nonfatal myocardial infarction, and unplanned clinically driven target vessel late revascularization. Prognostic value of post-PCI CFR was compared with that of FFR or FFR/CFR combination.
Results
After PCI completion, 13.7% showed post-PCI FFR ≤0.80 and 44.2% exhibited post-PCI CFR <2.5. Discordant results were observed in 42.5% (198/466). During 2.7 (1.8–3.3) years follow-up, 57 (12.2%) TVF were documented. The multivariable Cox proportional hazard regression analysis revealed that post-PCI FFR and post-PCI CFR were independent prognostic factors. ROC analysis revealed that the optimal cut-off values of post-PCI FFR and CFR values were 0.85 and 2.26, respectively. Significant differences in TVF were detected according to post-PCI FFR (≤0.85 vs >0.85: 17.8% vs 8.9%, P<0.05) and post-PCI CFR (≤2.26 vs >2.26: 20.5% vs 7.2%, P<0.01), although the reclassification ability for TVF was improved only with post-PCI CFR (net reclassification index 0.598; P<0.01; integrated discrimination index 0.038; P<0.01), but not with post-PCI FFR, in comparison with the clinical model. Compared with patients with FFR >0.85, those with post-PCI FFR ≤0.85 and CFR ≤2.26 showed significantly higher risk of TVF (8.9% vs 28.9%, P<0.01, HR 4.24, 95% CI 2.40–7.50, P<0.01), whereas those with post-PCI FFR <0.85 and CFR >2.26 had similar TVF risk (8.9% vs 9.2%, P=1.00, HR 1.01, 95% CI 0.47–2.16, P=0.97).
Conclusions
After PCI completion with newer-generation DES, discordant results between FFR and CFR were observed in 42.5%. Compared with post-PCI CFR, post-PCI FFR provided limited reclassification ability for TVF. Among patients with lower post-PCI FFR, only patients with lower post-PCI CFR showed significantly higher risk of TVF than those with higher post-PCI FFR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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11
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Hamaya R, Yonetsu T, Ueno H, Hoshino M, Sugiyama T, Sasano T, Kakuta T. Robust association between changes in coronary flow capacity following PCI and vessel-oriented outcomes. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1122] [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
Backgrounds
While trials show a comparative effectiveness of percutaneous coronary intervention (PCI) against medical therapy with respect to patient outcomes, deferring all elective PCI might be too simplistic, given the prognostic benefit differential according to several factors. Coronary flow capacity (CFC) is a potentially useful coronary flow (CF)-related physiologic marker of ischemia for guiding PCI indication [1,2]. However, the physiological/prognostic mechanics of the CFC guidance, which could be assessed by CFC changes following PCI, have not been investigated.
Objectives
To assess the determinants and prognostic implication of the change in the CFC status following PCI.
Methods
From a single center registry, 450 patients with chronic coronary syndrome (CCS) who underwent fractional flow reserve (FFR)-guided PCI with pre-/post-PCI coronary physiological assessments by thermodilution-method were included. CFC status was defined as follows [1]; normal CFC as CFR ≥2.80 with hyperemic CF (hCF) ≥3.70; mildly reduced CFC as CFR <2.80 and ≥2.10, combined with hCF <3.70 and ≥2.56; moderately reduced CFC as CFR <2.10 and ≥1.70, and 1/Tmn <2.56 and ≤2.00; and severely reduced CFC otherwise (CFR <1.70 and hCF <2.00). Associations between PCI-related changes in thermodilution method-derived CFC categories and incident target vessel failure (TVF) during a median follow-up of 4.3 (IQR: 2.5, 6.9) years were assessed by multivariate COX proportional hazard models.
Results
The mean (SD) age was 67.1 (10.0) years and there were 75 (16.7%) women. There were no differences in survival according to pre-PCI CFC status (P for linear trends = 0.22). Compared with patients showing no change in CFC categories after PCI, patients with category worsened, +1, +2, and +3 category improved had the hazard ratio (95% CI) for incident TVF of 2.27 (0.95, 5.43), 0.85 (0.33, 2.22), 0.45 (0.12, 1.63), and 0.14 (0.016, 1.30), respectively (P for linear trends = 0.0017). The relevant Kaplan-Meier curves were illustrated in the Figure, which highlights a best survival in those with +3 categories improvement (severely reduced to normal CFC) and worst in worsened CFC. After adjustment for confounders, one additional improvement in CFC status was associated with 0.61 (0.45, 0.83) times the hazard of TVF. CFC changes ≥3 categories were largely predicted by pre-PCI CFC with area under the curve of 0.94 (95% CI: 0.93, 0.96), and 48.6% of the variability of continuous CFC changes in ranks was explained solely by pre-PCI CFC, while only 12.4% by FFR.
Conclusion
CFC improvement following PCI, which was largely determined by the pre-PCI CFC status, was associated with lower risk of incident TVF in patients with CCS who underwent PCI. Therefore, CFC changes provide a mechanistic explanation on a potential favorable effect of PCI on reducing vessel-oriented outcome in lesions with reduced CFC and low FFR.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- R Hamaya
- Harvard T. H. Chan School of Public Health , Boston , United States of America
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiology , Tokyo , Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, cardiology , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, cardiology , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, cardiology , Tsuchiura , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Cardiology , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, cardiology , Tsuchiura , Japan
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12
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Nagamine T, Masahiro H, Sayama K, Matsuda K, Ueno H, Misawa T, Hada M, Sugiyama T, Yonetsu T, Sasano T, Kakuta T. Prevalence and culprit lesion plaque characteristics on optical coherence tomography in patients with non-st-segment elevation acute coronary syndrome with zero coronary calcification on coronary CTA. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1183] [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
CAC evaluated by non-contrast computed tomography is a marker of atherosclerosis. However, the characteristic features of CCTA and optical coherence tomography (OCT) of culprit lesions in patients with NSTE-ACS showing zero CAC remain unknown.
Objectives
This study aimed to assess the prevalence and characteristic features of culprit lesions on coronary CT angiography (CCTA) and optical coherence tomography (OCT) in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) showing zero coronary artery calcium (CAC).
Methods
A total of 176 consecutive patients with NSTE-ACS who underwent preprocedural CCTA and OCT were studied. Patients were divided into two groups according to their CAC (zero-CAC and non-zero-CAC groups). Baseline characteristics, CCTA and OCT findings were compared between these two groups.
Results
The prevalence of patients with zero-CACS was 15.9% (28/176). Patients in zero CAC group were younger (mean age, 55 vs. 65 years, P<0.001) and had a lower prevalence of diabetes (10.7 vs 37.2%, P=0.012) than non-zero CAC group. In zero CAC group, the lower prevalence of napkin ring sign (3.5% vs. 28.4%, P=0.028), smaller LV mass index (77.7 vs. 83.9, P=0.04), lower prevalence on spotty calcification (0 vs. 83.8%, P<0.001), lower epicardial fat volume (111.3 vs. 142.6 cm3, P=0.025), and lower pericoronary adipose tissue attenuation (−71.5 vs. −70.2 HU, P=0.07) on CCTA were observed. On OCT, the frequency of plaque erosion (82.1 vs. 44.6%, P<0.001) was significantly higher in zero-CACS group. The prevalence of lipid-rich plaque (46.4 vs. 86.5%, P<0.001), thin-cap fibroatheroma (17.9 vs. 46%, P=0.006), macrophage accumulation (46.4 vs. 81.8%, P<0.001) and cholesterol crystal (7 vs. 41.9%, P<0.001) were all significantly lower in zero-CAC group.
Conclusions
Zero CAC NSTE-ACS was not rare. Zero-CAC NSTE-ACS was characterized by specific phenotypes defined by the combined assessment of CCTA and OCT. Further studies are warranted if these characteristics of NSTE-ACS on preprocedural imaging studies provide prognostic information or guidance of a specific therapeutic approach.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Masahiro
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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13
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Sugiyama T, Kanaji Y, Hoshino M, Hada M, Misawa T, Nagamine T, Ueno H, Matsuda K, Sayama K, Yonetsu T, Sasano T, Kakuta T. Relationship between OCT-derived plaque characteristics, CTA-derived coronary inflammation, and CMR-derived global coronary flow reserve in patients with acute coronary syndrome. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.346] [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
The presence of layered plaque is suggestive of recurrent thrombotic events. However, the impact of layered plaque detected by optical coherence tomography (OCT) on coronary inflammation and coronary flow reserve remains unclear.
Purpose
We aimed to investigate the association of OCT-derived layered plaque with pericoronary adipose tissue inflammation assessed by coronary computed tomography angiography (cCTA) and global coronary flow reserve (G-CFR) assessed by cardiac magnetic resonance imaging (CMR) in patients with acute coronary syndrome (ACS).
Methods
We investigated 88 patients with first ACS who underwent preprocedural cCTA and OCT imaging of the culprit lesion, and CMR after percutaneous coronary intervention (PCI). All patients were divided into four groups according to the OCT-derived culprit plaque characteristics: layered vs. non-layered plaque; and plaque rupture vs. plaque erosion. Coronary inflammation was assessed by the mean value of pericoronary adipose tissue (PCAT) attenuation (−190 to −30 HU) of the three major coronary vessels. G-CFR was obtained by quantifying absolute coronary sinus flow at rest and during maximum hyperemia. CCTA and CMR findings were compared between the groups.
Results
In a total of 88 patients, layered plaque [L] with plaque rupture [PR] was observed in 25 patients, layered plaque with plaque erosion [PE] was observed in 26 patients, non-layered plaque [NL] with PR was observed in 23 patients, and non-layered plaque with PE was observed in 14 patients, respectively. Three-vessel-PCAT attenuation value (L-PR vs. L-PE vs. NL-PR vs. NL-PE; −68.13±6.18 vs. −69.01±6.72 vs. −69.76±4.04 vs. −74.61±5.63 HU, P=0.009) and culprit vessel PCAT attenuation value (L-PR vs. L-PE vs. NL-PR vs. NL-PE; −66.39±7.38 vs. −68.94±8.06 vs. −70.01±5.76 vs. −75.45±6.60 HU, P=0.003) showed the graded difference between the four groups. G-CFR value also showed the graded difference between the four groups (L-PR vs. L-PE vs. NL-PR vs. NL-PE; 2.26 [1.80–2.87] vs. 2.24 [1.72–3.13] vs. 2.97 [2.24–3.83] vs. 3.18 [2.67–4.08], P=0.022).
Conclusions
The presence of layered plaque at the culprit lesion was associated with high PCATA and low G-CFR in patients with ACS. Detection of layered plaque may indicate increased pericoronary inflammation and impaired coronary flow reserve, potentially providing the risk stratification in patients with ACS.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- T Sugiyama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Nagamine
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Matsuda
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - K Sayama
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
| | - T Yonetsu
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Sasano
- Tokyo Medical and Dental University , Tokyo , Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital , Tsuchiura , Japan
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14
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Hamada H, Hayama T, Ijuin A, Miyakoshi A, Yamamoto M, Ueno H, Saito M, Tochihara S, Takeshima T, Tanoshima M, Takeshima K, Sakakibara H, Yumura Y, Miyagi E, Murase M. O-183 Frequent spontaneous abortion in pregnancies followed by ICSI using frozen sperm from patients with testicular germ cell tumor (TGCT). Hum Reprod 2022. [DOI: 10.1093/humrep/deac105.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Study question
Despite the high rate of sperm chromosome abnormalities in testicular germ cell tumor (TGCT), why is newborn aneuploidy rate in pregnancies with TGCT patient normal?
Summary answer
Miscarriage rate is higher in the pregnancy of TGCT patients than of non-TGCT cancer patients, although the pregnancy rate in ICSI was not significantly different.
What is known already
Previous reports showed higher sperm aneuploidy in TGCT patients than control males. The sperm aneuploidy rate is high before treatment, and after radical treatments peaked at 6 months after treatment and remained high until 24 months after treatment. However, in the Swedish government base study, the rate of newborn malformations including aneuploidy in all pregnancy with TGCT patients was higher than without TGCT, but not statistically significant. In only natural pregnancies, the rate was not significantly different between the two groups. The cause for discrepancy within sperm aneuploidy and newborn aneuploidy was not well clarified.
Study design, size, duration
To clarify the mechanism for the purifying selection of aneuploid sperm in conception, we examined ICSI cases with TGCT patients that did not include natural sperm competition and compared to controls with non-TGCT cancer patient, who have normal rate of aneuploid sperm. By investigating ICSI outcomes, we aimed to determine which stage of embryonic development are affected by the sperm of TGCT patients.
Participants/materials, setting, methods
Under ethical review of Yokohama city university, the 10 TGCT patients (123 oocytes) and 16 non-TGCT cancer patients (251 oocytes) who underwent ICSI with their frozen sperm from 2012 to 2021 were enrolled. Fertilization, embryo viability and embryo transfer outcomes (pregnancy and miscarriage rate) were examined between two groups underwent ICSI with cryopreserved sperm for fertility preservation. Clinical information was retrospectively collected from medical records.
Main results and the role of chance
The patients' age of sperm cryopreservation was 21-56 years old. 10 cases of TGCT were diagnosed as seminoma (3), non seminoma (6), and unknown (2). 15 cases of non-TGCT were diagnosed as malignant blood diseases (9), prostate cancer (2), bladder cancer (1), and others (3). In both groups, all patients were treated by ICSI with cryopreserved sperm obtained prior to chemotherapy. The mean age of female partners in TGCT was 33.2±3.5 years and not different with 35.8±3.4 years in non-TGCT meaning no different age factor. The fertilization rate, viable embryo rate, pregnancy rate and chemical abortion rate of TGCT vs non-TGCT group were 76.4% vs 67.7%, 64.3% vs 61.7%, 37.1% vs 21.7%, 7.1% vs 23.1%, respectively. Those developmental evaluations were not significantly different between two groups. However, spontaneous abortion rate was significantly higher 46.2% in TGCT group than 10% in non-TGCT group (p < 0.05). Further, in our follow-up, no congenital malformations in the babies born in either group (5 babies in TGCT vs 7 babies in non-TGCT group). The outcome of ICSI using sperm in TGCT patients show normal pregnancy rate but include higher spontaneous abortions rate, suggesting aneuploid embryo were negatively purifying selected under post-implantation stage.
Limitations, reasons for caution
Because ICSI with fertility-preserving frozen sperm in TGCT patient is rare even in reproduction center in general university hospital, single center analysis is still small and limited. More case reports and studies for TGCT fertility preservation are needed for more accurate evaluation.
Wider implications of the findings
In TGCT patients, chromosome aberrations and DNA fragmentation of sperm may not be apparent in natural pregnancies with normal sperm competition, but may become apparent as spontaneous abortions when ICSI were performed, suggesting PGT-A can predict and avoid the hidden risk of repeated pregnancy loss in ICSI to TGCT patients.
Trial registration number
not applicable
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Affiliation(s)
- H Hamada
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - T Hayama
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
- Yokohama City University Medical Center , Gynecology, Yokohama, Japan
| | - A Ijuin
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
- Yokohama City University, Obstetrics and Gynecology , Yokohama, Japan
| | - A Miyakoshi
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - M Yamamoto
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - H Ueno
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - M Saito
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - S Tochihara
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - T Takeshima
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - M Tanoshima
- Yokohama City University Medical Center, Clinical Genetics , Yokohama, Japan
| | - K Takeshima
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - H Sakakibara
- Yokohama City University Medical Center , Gynecology, Yokohama, Japan
| | - Y Yumura
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
| | - E Miyagi
- Yokohama City University, Obstetrics and Gynecology , Yokohama, Japan
| | - M Murase
- Yokohama City University Medical Center, Reproductive Medical Center , Yokohama, Japan
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Imamura T, Sobajima M, Tanaka S, Ushijima R, Fukuda N, Ueno H, Kinugawa K. Decoupling Between Pulmonary Artery Diastolic and Wedge Pressure Following TAVR. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1466] [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: 10/18/2022] Open
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16
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Imamura T, Oshima A, Onoda H, Tanaka S, Ushijima R, Sobajima M, Fukuda N, Ueno H, Kinugawa K. Clinical implications of troponin-T elevations following TAVR. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehab849.104] [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
Funding Acknowledgements
Type of funding sources: None.
Background
Baseline and post-procedural elevations in serum troponin-T levels are associated with increased morbidity and mortality following transcatheter aortic valve replacement (TAVR). However, the prognostic impact of change in serum troponin-T level following TAVR remains unknown.
Methods
Among the patients with severe aortic stenosis who underwent TAVR, those with baseline serum troponin-T level ≥51.5 ng/L were excluded. The impact of increases in serum troponin-T level to an abnormally high range (≥51.5 ng/L) following TAVR on 2-year cardiovascular death or heart failure readmissions was investigated.
Results
Among 189 included patients (median 86 years old, 28% men), serum troponin-T level increased in 79 patients following TAVR. An increase in serum troponin-T was associated with a higher rate of 30-day adverse events, predominantly due to pacemaker implantation for complete atrio-ventricular block, and a higher 2-year cumulative incidence of the primary endpoint (hazard ratio 3.97, 95% confidence interval 1.51-10.4, p = 0.005) adjusted for the use of balloon-expandable valve and post-TAVR pacemaker implantation (Figure 1).
Conclusion
Post-procedural increase in serum troponin-T level was associated with adverse clinical outcomes following TAVR. Abstract Figure. Cumulative incidence of endpoint
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Affiliation(s)
| | - A Oshima
- University of Toyama, Toyama, Japan
| | - H Onoda
- University of Toyama, Toyama, Japan
| | - S Tanaka
- University of Toyama, Toyama, Japan
| | | | | | - N Fukuda
- University of Toyama, Toyama, Japan
| | - H Ueno
- University of Toyama, Toyama, Japan
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Boulay F, Simpson GS, Ichikawa Y, Kisyov S, Bucurescu D, Takamine A, Ahn DS, Asahi K, Baba H, Balabanski DL, Egami T, Fujita T, Fukuda N, Funayama C, Furukawa T, Georgiev G, Gladkov A, Hass M, Imamura K, Inabe N, Ishibashi Y, Kawaguchi T, Kawamura T, Kim W, Kobayashi Y, Kojima S, Kusoglu A, Lozeva R, Momiyama S, Mukul I, Niikura M, Nishibata H, Nishizaka T, Odahara A, Ohtomo Y, Ralet D, Sato T, Shimizu Y, Sumikama T, Suzuki H, Takeda H, Tao LC, Togano Y, Tominaga D, Ueno H, Yamazaki H, Yang XF, Daugas JM. Boulay et al. Reply. Phys Rev Lett 2021; 127:169202. [PMID: 34723612 DOI: 10.1103/physrevlett.127.169202] [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] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/31/2021] [Indexed: 06/13/2023]
Affiliation(s)
- F Boulay
- CEA, DAM, DIF, 91297 Arpajon cedex, France
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- GANIL, CEA/DSM-CNRS/IN2P3, BP55027, 14076 Caen cedex 5, France
| | - G S Simpson
- LPSC, CNRS/IN2P3, Université Joseph Fourier Grenoble 1, INPG, 38026 Grenoble Cedex, France
| | - Y Ichikawa
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - S Kisyov
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 077125 Bucharest-Măgurele, Romania
| | - D Bucurescu
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 077125 Bucharest-Măgurele, Romania
| | - A Takamine
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D S Ahn
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Asahi
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - H Baba
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D L Balabanski
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Extreme Light Infrastructure-Nuclear Physics (ELI-NP), Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 077125 Bucharest-Măgurele, Romania
| | - T Egami
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Advanced Sciences, Hosei University, 3-7-2 Kajino-cho, Koganei, Tokyo 184-8584, Japan
| | - T Fujita
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Osaka University, Machikaneyama 1-1 Toyonaka, Osaka 560-0034, Japan
| | - N Fukuda
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - C Funayama
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - T Furukawa
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Metropolitan University, 1-1 Minami-Ohsawa, Hachioji, Tokyo 192-0397, Japan
| | - G Georgiev
- CSNSM, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay Campus, France
| | - A Gladkov
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu 702-701, South Korea
| | - M Hass
- Department of Particle Physics, Weizmann Institute of Science, Rehovot 76100, Israel
| | - K Imamura
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Meiji University, 1-1-1 Higashi-Mita, Tama, Kawasaki, Kanagawa 214-8571, Japan
| | - N Inabe
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Y Ishibashi
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-5877, Japan
| | - T Kawaguchi
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Advanced Sciences, Hosei University, 3-7-2 Kajino-cho, Koganei, Tokyo 184-8584, Japan
| | - T Kawamura
- Department of Physics, Osaka University, Machikaneyama 1-1 Toyonaka, Osaka 560-0034, Japan
| | - W Kim
- Department of Physics, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu 702-701, South Korea
| | - Y Kobayashi
- Department of Informatics and Engineering, University of Electro-Communication, 1-5-1 Chofugaoka, Chohu, Tokyo 182-8585, Japan
| | - S Kojima
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - A Kusoglu
- CSNSM, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay Campus, France
- Department of Physics, Faculty of Science, Istanbul University, Vezneciler/Faith, 34134 Istanbul, Turkey
| | - R Lozeva
- CSNSM, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay Campus, France
| | - S Momiyama
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - I Mukul
- Department of Particle Physics, Weizmann Institute of Science, Rehovot 76100, Israel
| | - M Niikura
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - H Nishibata
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Osaka University, Machikaneyama 1-1 Toyonaka, Osaka 560-0034, Japan
| | - T Nishizaka
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Advanced Sciences, Hosei University, 3-7-2 Kajino-cho, Koganei, Tokyo 184-8584, Japan
| | - A Odahara
- Department of Physics, Osaka University, Machikaneyama 1-1 Toyonaka, Osaka 560-0034, Japan
| | - Y Ohtomo
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - D Ralet
- CSNSM, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay Campus, France
| | - T Sato
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - Y Shimizu
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Sumikama
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Suzuki
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Takeda
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - L C Tao
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University, Beijing 100871, China
| | - Y Togano
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - D Tominaga
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Advanced Sciences, Hosei University, 3-7-2 Kajino-cho, Koganei, Tokyo 184-8584, Japan
| | - H Ueno
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Yamazaki
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - X F Yang
- Instituut voor Kern-en Stralingsfysica, K.U. Leuven, Celestijnenlaan 200D, 3001 Leuven, Belgium
| | - J M Daugas
- CEA, DAM, DIF, 91297 Arpajon cedex, France
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
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Hayama T, Ijuin A, Ueno H, Hamada H, Miyakoshi A, Nishi M, Saito M, Hamanoue H, Komeya M, Takeshima T, Kuroda S, Sakakibara H, Yumura Y, Miyagi E, Murase M. P–572 Purifying selection for aneuploidy cells in mosaicism embryo at post-implantation stage. Hum Reprod 2021. [DOI: 10.1093/humrep/deab130.571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Study question
Why low ratio mosaicism embryos develop to normal karyotype babies?
Summary answer
Our in vitro implantation assay clarified purifying selection for aneuploid cells in post implantation embryos.
What is known already
There are some reports about healthy live birth after transfer of mosaic embryos, which was reported for the first time from Italy in 2015. It is also reported that the abnormal cell is screened with the mouse in the embryo development, and only a normal cell contributes to the development. But it has not been examined in human.
Study design, size, duration
To clarify the change of aneuploid cells and mitochondrial activity in human embryo, we biopsied several parts from one blastocyst and examined karyotype. After in vitro implantation assay for biopsied embryos, we compared the karyotype of biopsy sample with that of cultured cell mass.
Participants/materials, setting, methods
Under the ethical review of Yokohama City University and informed consent with patients, we collected human surplus blastocysts those are donated after successful clinical treatment or discarded because of poor development grade. We biopsied multiple parts from one blastocyst and cultured the biopsied embryos, and extracted whole DNA from the biopsy samples and cultured embryos. Karyotyping by next generation sequencing were performed.
Main results and the role of chance
We analyzed 34 samples from 11 embryos, including 25 biopsy sample from 11 embryos and 9 cell mass from 7 cultured embryos. In the karyotype tracking results, even though biopsy sample analysis before the culture were uniformed aneuploid or chromosome mosaic, the developing embryo cell mass had normal karyotype. In one embryo as an example, among the three biopsied extra trophectoderm samples from that, two of them were mosaic, and one of them had uniformed chromosome 21 trisomy and chromosome 16 mosaic monosomy. But the embryo formed multiple cell mass in implantation assay. We examined karyotype of three cell mass, and the result from all were normal karyotype. We suggested that the chromosome aberration cells were screened in the human embryo development, and when the function was not carried out the embryo stopped the development.
Limitations, reasons for caution
Because of small number of samples available, we need more samples for a more accurate evaluation. Furthermore, we cannot evaluate the absolute mechanism that cells with chromosome aberration decreases.
Wider implications of the findings: Conventional PGT-A techniques are based on uniformed embryos developing hypothesized past time. As showed in some clinical reports, PGT-A can reduce of spontaneous abortion and chance of embryo transfer. Thinking about aneuploid cell purifying system in embryo development, effectiveness of PGT-A should be more questionable for infertility treatment.
Trial registration number
A200326004
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Affiliation(s)
- T Hayama
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - A Ijuin
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Ueno
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Hamada
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - A Miyakoshi
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - M Nishi
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - M Saito
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Hamanoue
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - M Komeya
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - T Takeshima
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - S Kuroda
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - H Sakakibara
- Yokohama City University Medical Center, Department of Gynecology, Yokohama-shi- Kanagawa, Japan
| | - Y Yumura
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
| | - E Miyagi
- Yokohama City University, Department of Gynecology, Yokohama-shi- Kanagawa, Japan
| | - M Murase
- Yokohama City University Medical Center, Center for Reproductive Medicine, Yokohama-shi- Kanagawa, Japan
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Oki E, Watanabe J, Sato T, Kagawa Y, Kuboki Y, Ikeda M, Ueno H, Kato T, Kusumoto T, Masuishi T, Yamaguchi K, Kanazawa A, Nishina T, Uetake H, Yamanaka T, Yoshino T. Impact of the 12-gene recurrence score assay on deciding adjuvant chemotherapy for stage II and IIIA/B colon cancer: the SUNRISE-DI study. ESMO Open 2021; 6:100146. [PMID: 33984677 PMCID: PMC8134704 DOI: 10.1016/j.esmoop.2021.100146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Recent advances in adjuvant chemotherapy for early colon cancer have widened physicians' recommendations on the regimen and duration (3 or 6 months) of the treatment. We conducted this prospective study to evaluate whether the 12-gene recurrence score (12-RS) assay affected physicians' recommendations on adjuvant treatment selection. PATIENTS AND METHODS Patients with stage IIIA/IIIB or stage II colon cancer were enrolled. After the patients discussed adjuvant treatment with their treating physicians, the physicians filled in the questionnaire before assay indicating the treatment recommendation. When the 12-RS assay results were available, the physicians again filled in the questionnaire after assay. The primary endpoint was the rate of change in treatment recommendations from before to after the assay, with a threshold rate of change being 20%. Patients with stage IIIA/B to II were enrolled in a ratio of 2 : 1. RESULTS Overall, the treatment recommendations changed in 40% of cases after obtaining 12-RS assay results. Recommendations were changed in 45% (80/178; 95% confidence interval, 37% to 53%; P < 0.001) and 30% (29/97; 95% confidence interval, 21% to 40%; P < 0.001) of patients with stage IIIA/B and II colon cancer, respectively. Patients with stage IIIA/B cancer had significantly more change than those with stage II cancer (P = 0.0148). From before to after the 12-RS assay, the percentage of patients whose physicians reported being confident in their treatment recommendations significantly increased from 54% to 81% in stage IIIA/B (P < 0.001) and from 65% to 83% in stage II (P < 0.001). CONCLUSION Our study confirmed the usefulness of the 12-RS assay in aiding the physician-patient decision-making process for tailoring adjuvant chemotherapy for stage IIIA/B colon cancer.
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Affiliation(s)
- E Oki
- Department of Surgery and Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - J Watanabe
- Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, Yokohama, Japan
| | - T Sato
- Department of Colorectal Surgery, Kitasato University Hospital, Kanagawa, Japan
| | - Y Kagawa
- Department of Surgery, Kansai Rosa Hospital, Hyogo, Japan
| | - Y Kuboki
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
| | - M Ikeda
- Department of Surgery, Hyogo College of Medicine, Hyogo, Japan
| | - H Ueno
- Department of Surgery, National Defense Medical College, Saitama, Japan
| | - T Kato
- Department of Surgery, NHO Osaka National Hospital, Osaka, Japan
| | - T Kusumoto
- Department of Gastroenterological Surgery, NHO National Kyushu Medical Center, Fukuoka, Japan
| | - T Masuishi
- Department of Clinical Oncology, Aichi Cancer Center Hospital, Aichi, Japan
| | - K Yamaguchi
- Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan
| | - A Kanazawa
- Department of Gastroenterological Surgery, Shimane Prefectural Central Hospital, Shimane, Japan
| | - T Nishina
- Department of Gastrointestinal Medical Oncology, NHO Shikoku Cancer Center, Ehime, Japan
| | - H Uetake
- Department of Specialized Surgeries, Tokyo Medical and Dental University, Tokyo, Japan
| | - T Yamanaka
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan.
| | - T Yoshino
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Chiba, Japan
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Goto E, Ishikawa H, Okuhara T, Ueno H, Okada H, Fujino Y, Kiuchi T. Presenteeism among workers: health-related factors, work-related factors and health literacy. Occup Med (Lond) 2020; 70:564-569. [PMID: 33180107 DOI: 10.1093/occmed/kqaa168] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Presenteeism is an important factor in workers' health. However, few studies have examined how variables such as socio-economic status, health status, workplace status and health literacy correlate with and affect presenteeism. AIMS To assess the correlates of presenteeism with a focus on health-related factors, work-related factors and health literacy. METHODS We conducted a cross-sectional study of 2914 Japanese workers from one company. We used a self-administered questionnaire to assess socio-demographic characteristics, health status, work environment, presenteeism and health literacy. RESULTS Forty-one per cent of participants were under 40 years of age and 70% were male. We found that 59% of the participants were at high risk of presenteeism. Presenteeism was associated with sex, age, household income, marital status, health-related factors (i.e. self-rated health status, dietary choices, exercise habits), work-related factors (i.e. workplace support, job demands, job control) and health literacy. Logistic regression analyses indicated that presenteeism was associated with self-rated health status, overtime hours, workplace support, job demands, job control and health literacy after adjusting for sex, age and income. CONCLUSIONS Health-related factors, work-related factors and health literacy are all associated with presenteeism. Improving the workplace environment, especially factors such as overtime working hours, workplace support, job demands and job control, and increasing health literacy may reduce presenteeism among general office workers.
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Affiliation(s)
- E Goto
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - H Ishikawa
- Graduate School of Public Health, Teikyo University, Tokyo, Japan
| | - T Okuhara
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - H Ueno
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - H Okada
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Y Fujino
- Department of Environmental Epidemiology, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - T Kiuchi
- Department of Health Communication, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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21
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Nakamura M, Imamura T, Ueno H, Kinugawa K. Impact of the angle between aortic and mitral annulus on the occurrence of hemolysis during Impella support. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1238] [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
Hemolysis of Impella is known as a major comorbidity and adequate device positioning and optimization of volume status are recommended. However, we have sometimes experienced hemolysis refractory to these adjustments and anatomical feature appears to be crucial in such cases.
Methods
We enrolled 26 patients (median 71 y; BSA 1.6 m2; LVEF 27%) with cardiogenic shock who received Impella insertion from March 2018 to November 2019. The angle of the aortic and mitral annulus which was drawn at the apical 3-chamber view on echocardiography, just before or after Impella insertion was measured (Figure). Hemolytic event was defined as follows; (1) Gross dark red urine and elevation of serum LDH level after initiation of Impella support were seen and subsequently required to lower the support level of Impella under P6. (2) Blood sample data indicating hemolysis (i.e. elevation of LDH level over 1.5 fold of normal range, anemia complicated with decreased haptoglobin, the elevation of total bilirubin level accompanied indirect bilirubin elevation) was found and subsequently required to initiate continuous hemodiafiltration.
Results
The freedom from hemolytic event was significantly lower in the narrow angle group (<126.5 degrees, Figure A) compared with the wide angle group (≥126.5 degrees, Figure B) (18% vs 83%, p<0.0001). The narrow angle was a significant risk factor of hemolytic event with an unadjusted hazard ratio 13.9 (95% confidence interval 2.88–67.2, p=0.0499) and a hazard ratio 15.5 (95% confidence interval 3.15–76.3, p=0.0008) adjusted for lower pulmonary artery pulsatility index, which was another risk factor significant in the univariate analyses. Furthermore, 30-day survival rate was significantly lower in the narrow angle group compared with the wide angle group (63% vs 100%, p=0.0116).
Conclusions
The narrow angle (<126.5 degrees) was an independent risk factor of hemolytic event and 30-day survival was lower compared with the wide angle group.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
| | | | - H Ueno
- University of Toyama, Toyama, Japan
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22
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Hoshino M, Yang S, Sugiyama T, Zhang J, Kanaji Y, Yamaguchi M, Hada M, Sumino Y, Nogami K, Ueno H, Misawa T, Yonetsu T, Koo B, Kakuta T. Prognostic value of peri-coronary adipose tissue attenuation and whole vessel and lesion plaque quantification on Coronary Computed Tomography Angiography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0155] [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
Peri-coronary adipose tissue attenuation expressed by fat attenuation index (FAI) on coronary CT angiography (CCTA) reflects peri-coronary inflammation and is associated with cardiac mortality. CCTA also provides two-dimensional and three-dimensional quantification of the individual component of atherosclerotic plaque and entire vessel. The atherosclerotic burden or disease extent in entire epicardial coronary arteries provides prognostic information in patients with coronary artery disease.
Purpose
This study sought to explore the prognostic significance of FAI values and whole vessel and lesion plaque quantification on CCTA in stable patients with intermediate epicardial stenosis evaluated by fractional flow reserve (FFR).
Methods
A total of 277 patients (277 lesions) with intermediate coronary stenosis who underwent FFR measurement and CCTA were studied. FAI was assessed by the crude analysis of the mean CT attenuation value (−190 to −30 Hounsfield units; higher values indicating inflammation) on CCTA. CT findings including whole vessel and lesion plaque quantification, and target vessel myocardial mass were investigated. Major adverse cardiovascular outcome (MACE) was defined as all cause death, cardiac death, myocardial infarction, unplanned revascularization, and heart failure requiring admission. Survivals from MACE were assessed.
Results
The mean FAI and the median FFR values were −71.6 and 0.77, respectively. FFR values were weakly albeit significantly correlated with FAI values. (r=−0.016, P=0.008.) MACE was occurred 43 (15.5%) patients during 5 years F-up. ROC analyses revealed that best cut-off value of FAI to predict MACE was −73.1. Kaplan-Meier analysis revealed that lesions with FAI ≥−73.1 had a significantly higher risk of MACE. (Chi-square 5.5, P=0.019) FFR values and the percutaneous coronary intervention were not predictive of MACE. Multivariate COX proportional hazards regression analysis revealed that age, remodeling index, and lesions with FAI ≥−73.1 were independent predictors of MACE.
Conclusion
The peri-coronary inflammation evaluated by FAI and CT remodeling index enhances cardiac risk prediction in chronic coronary syndrome patients with intermediate lesions. Non-invasive comprehensive CT assessment may help identify high risk patients of subsequent clinical events and provide enhanced patient management.
Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): This study was supported in part by an unrestricted research grant from St. Jude Medical (Abbot Vascular, Santa Clara, CA, USA). The company had no role in study design, conduct, data analysis or manuscript preparation.
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Affiliation(s)
- M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - S Yang
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - J Zhang
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - B Koo
- Seoul National University Hospital, Seoul, Korea (Republic of)
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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23
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Nogami K, Kanaji Y, Sugiyama T, Hoshino M, Yamaguchi M, Hada M, Sumino Y, Misawa T, Hirano H, Ueno H, Kakuta T. Prognostic value of unrecognized myocardial infarction and hyperemic coronary sinus flow in patients undergoing elective percutaneous coronary intervention. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1381] [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
Cardiac magnetic resonance (CMR) imaging is a useful instrument for the assessment of pathological and functional conditions without the need for ionizing radiation, radioactive tracers, or intravascular catheterization. Both unrecognized myocardial infarction (UMI) and impaired global myocardial blood flow (g-MBF) have been reported to be strongly associated with worse outcome in patients with cardiovascular disease. However, their combined efficacy remains undetermined.
Purpose
We sought to assess the prognostic value of the presence of UMI and pre-procedural hyperemic g-MBF evaluated by phase-contrast cine magnetic resonance imaging (PC-CMR) in patients with chronic coronary syndrome who underwent elective percutaneous coronary intervention (PCI).
Methods
A total of 177 patients with de novo functionally significant stenosis who underwent pre-PCI CMR and PCI between September, 2016 and March, 2019 were retrospectively studied. UMI was defined as a scar detected by late gadolinium enhancement (LGE) without previously diagnosed MI. g-MBF was assessed by quantifying coronary sinus flow using PC-CMR at rest and hyperemic state. The predictors of major adverse cardiac events (MACE; cardiac death, nonfatal myocardial infarction, clinically driven unplanned revascularization, or hospitalization for congestive heart failure) during follow-up were investigated.
Results
UMI was detected in 40 (27.7%) patients and rest and maximal hyperemic g-MBF evaluated by the coronary sinus flow obtained by PC-CMR were 0.95 ml/min/g and 2.26 ml/min/g, respectively. During the median follow-up of 26 months, cardiovascular death occurred in 1 patient (0.6%), nonfatal myocardial infarction occurred in 4 patients (2.3%), and clinically driven revascularization and hospitalization due to congestive heart failure occurred in 25 patients (14.1%) and 3 patients (1.7%) patients, respectively. In patients with MACE, hyperemic g-MBF was significantly lower and the prevalence of UMI were significantly higher compared with those without MACE (1.94 ml/min/g vs 2.36 ml/min/g P=0.014; 48.3% vs 23.6%, P=0.011). Cox proportional hazards model indicated that impaired hyperemic g-MBF (<2.00 ml/min/g) and the presence of UMI were significant predictors of MACE (HR 2.22, 95% CI 1.060–4.640, P=0.034; HR 2.660, 95% CI 1.290–5.470, P=0.008). During follow-up, cardiac event-free survival was significantly worse in patients with impaired hyperemic g-MBF (<2.00 ml/min/g) and UMI (log-rank χ2=11.0, P=0.010).
Conclusion
In patients with chronic coronary syndrome undergoing elective PCI, the combined assessment of UMI and hyperemic g-MBF obtained by preprocedural noninvasive CMR may provide significant prognostic information.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Nogami
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Hirano
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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24
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Hada M, Kanaji Y, Ueno H, Nogami K, Misawa T, Sumino Y, Yamaguchi M, Sugiyama T, Yonetsu T, Kakuta T. Diagnostic value of myocardial perfusion CT to detect coexisting microvascular dysfunction in patients with obstructive epicardial coronary disease. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1385] [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
The usefulness of computed tomography myocardial perfusion (CTP) to assess hemodynamically significant coronary artery lesions has been previously reported. However, the diagnostic value of quantitative evaluation of regional absolute coronary flow by CTP to detect microvascular dysfunction remains unknown.
Purpose
The aim of study is to assess the diagnostic value of preprocedural CTP to detect coexisting microvascular dysfunction with functionally significant epicardial stenosis in patients with chronic coronary syndromes.
Methods and results
Thirty-three chronic coronary syndrome patients with de novo single functionally significant stenosis (Fractional flow reserve [FFR]<0.80) who underwent noncomplicated PCI were investigated. In CTP analysis, regional myocardial blood flow (MBF) at rest (rest-MBF) and hyperemia (hyperemic-MBF) were evaluated semi-automatically. Clinical characteristics, pressure-temperature sensor-chipped wire-based information and CTP findings were compared between groups with and without microvascular dysfunction defined by the index of microcirculatory resistance (IMR) (IMR≥25, n=17, IMR<25, n=16, respectively).
The determinants of coexistence of microvascular dysfunction and functional epicardial stenosis were determined. In invasive wire-based analysis, FFR, coronary flow reserve (CFRwire) and IMR were 0.68 (0.57–0.72), 1.61 (1.00–1.98), and 26.7 (19.3–39.4) respectively.
In CTP analysis, rest and hyperemic-MBF and CFR derived from CTP (CFRCTP; calculated as hyperemic-MBF/rest-MBF) were 2.00 (1.31–2.35) ml/min/g, 4.03 (2.11–5.44) ml/min/g, and 2.09 (1.49–2.09) respectively.
In the lesions with IMR>25, hyperemic-MBF was significantly lower than that in IMR<25 (3.42 [1.89–4.34] vs 4.50 [3.44–5.99], p=0.031), although there was no significant difference in regional rest-MBF and CFRCTP (1.75 [1.31–2.24] vs 2.05 [1.35–2.46], p=0.439, and 1.83 [1.21–2.11] vs 2.61 [1.91–2.91], p=0.101 respectively). Receiver operating characteristic curve analysis of hyperemic-MBF detecting IMR>25 showed area under the curve of 0.72 (0.54–0.90), sensitivity of 47% and specificity of 94%.
Conclusion
Quantitative assessment of absolute coronary flow by CTP may help detect coexisting microvascular dysfunction in patients with significant epicardial stenotic lesions.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Hada
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Department of cardiovascular medicine, Tsuchiura, Japan
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25
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Kanbayashi Y, Amaya F, Ikoma K, Ueno H, Tabuchi Y, Ishikawa T, Takayama K, Taguchi T. Predictors of the usefulness of mirogabalin for neuropathic pain: a single-institution retrospective study. Pharmazie 2020; 75:602-605. [PMID: 33239138 DOI: 10.1691/ph.2020.0741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 09/29/2022]
Abstract
Mirogabalin is a novel, preferentially selective α2δ-1 ligand to treat neuropathic pain. However, this agent is not always effective for patients with neuropathic pain. We therefore attempted to identify factors that could predict the efficacy of mirogabalin. The study comprised 133 patients given mirogabalin for alleviation of neuropathic pain between April and November 2019 at our hospital. Variables were extracted from medical records for regression analysis of factors associated to alleviation of neuropathic pain. We evaluated the effect of mirogabalin at two weeks after administration. Groups were categorized according to degree of improvement: poor, effective, or very effective. Multivariate ordered logistic regression analysis was conducted to identify predictors for the usefulness of mirogabalin. Threshold measures were analysed using receiver operating characteristic (ROC) curves. Maintenance dose [odds ratio (OR) = 0.90; 95% confidence interval (CI) = 0.84-0.98; P = 0.01], concomitant use of opioids (OR = 0.26, 95% CI = 0.08-0.83; P = 0.023) and Neurotropin® (NTP) (OR = 4.78, 95% CI =1.04-21.93; P = 0.044) were factors significantly correlated to the effect of mirogabalin. ROC curve analysis of the effective group indicated a threshold maintenance dose of≤ 20 mg/day (area under the curve [AUC] = 0.53). In conclusion, maintenance dose (≤ 20 mg), concomitant use of opioids and NTP were identified as predictors for the utility of mirogabalin.
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Affiliation(s)
- Y Kanbayashi
- Department of Outpatient Oncology Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Education and Research Center for Clinical Pharmacy, Osaka University of Pharmaceutical Sciences, Osaka; Department of Endocrine and Breast Surgery, Graduate School of Medical Science, Kyoto, Japan;,
| | - F Amaya
- Departments of Pain Management & Palliative Care Medicine, Graduate School of Medical Science, Kyoto, Japan
| | - K Ikoma
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto, Japan
| | - H Ueno
- Department of Anaesthesiology, Graduate School of Medical Science, Kyoto, Japan
| | - Y Tabuchi
- Department of Outpatient Oncology Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Pharmacy, University Hospital, Graduate School of Medical Science, Kyoto, Japan
| | - T Ishikawa
- Department of Outpatient Oncology Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Molecular Gastroenterology and Hepatology, Graduate School of Medical Science, Kyoto, Japan
| | - K Takayama
- Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - T Taguchi
- Department of Outpatient Oncology Unit, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan; Department of Pulmonary Medicine, Kyoto Prefectural University of Medicine, Kyoto, Japan
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Sugiyama T, Kanaji Y, Hoshino M, Yamaguchi M, Hada M, Misawa T, Sumino Y, Nogami K, Ueno H, Kakuta T. Prognostic value of fat attenuation index of pericoronary adipose tissue surrounding left anterior descending artery on coronary computed tomography angiography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1346] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recent studies reported the association between elevated fat attenuation index (FAI) of pericoronary adipose tissue (PCAT) on coronary computed tomography angiography (CTA) and worse cardiac outcomes.
Purpose
We investigated the prognostic value of increased FAI-defined coronary inflammation status in patients with coronary artery disease.
Methods
Three-hundred fifty-eight patients (127 acute coronary syndromes [ACS], 231 stable coronary artery disease) with left anterior descending artery (LAD) as a culprit vessel who underwent coronary CTA were retrospectively studied. The FAI defined as the mean CT attenuation value of PCAT (−190 to −30 Hounsfield Unit [HU]) was measured at the proximal 40-mm segment of LAD. All subjects were divided into two groups according to the median value of FAI in the LAD. The association between the incidence of major adverse cardiac events (MACE) including all-cause death, myocardial infarction, heart failure, target and non-target vessel revascularization were evaluated.
Results
In a total of 358 patients, median FAI values surrounding the LAD was −71.46 (interquartile range, −77.10 to −66.34) HU. Thirty-eight patients (10.6%) experienced MACE during the follow-up period (median, 818 days). Kaplan-Meier analysis revealed that high FAI-LAD (>−71.46 HU [median]) was significantly associated with the incidence of MACE (log-rank test, chi-square = 4.183, P=0.041) (Figure).
Conclusions
In patients with coronary artery disease with culprit LAD lesions, elevated FAI of PCAT surrounding the LAD was associated with worse clinical outcomes. Assessment of FAI may have a potential for potential for non-invasive risk-stratification by coronary CTA.
Kaplan-Meier analysis for MACE
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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27
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Sumino Y, Yonetsu T, Ueno H, Nogami K, Misawa T, Hada M, Yamaguchi M, Hoshino M, Kanaji Y, Sugiyama T, Kakuta T. Impact of neoatherosclerosis observed at very late phase after coronary stent implantation on subsequent adverse events. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0310] [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
Despite the reduction in late thrombotic events with newer generation coronary stents, late stent failure remains a concern following stent implantation. Neoatherosclerosis (NA) is a cause of in-stent restenosis and acute thrombotic occlusion originating from the stented segment by disruption of the in-stent atheroma. Although the clinical impact of NA at 1 year has been reported, clinical significance of NA observed at very later phase remains to be determined. We sought to investigate the association between optical coherence tomography (OCT) findings at very late phase after stenting and subsequent clinical outcomes.
Methods
A total of 195 patients with 316 stents (including 74 bare metal stents, 48 first-generation DES, and 194 second-generation DES) without stent failure who underwent OCT examination at >3 years (4.9 [3.9- 5.8] years) after stent implantation according to the prespecified protocol were investigated. OCT analysis included the presence of lipid-laden neointima, macrophage, malapposition, thrombus, and plaque rupture within the stents. NA was defined as having lipid-laden neointima. The criteria for the diagnosis of NA were signal-poor region in continuous flames, lipid length longer than 0.3 mm, and invisible stent strut at NA site. Quantitative OCT measurement included lipid length (LL), lipid arc, minimum lumen area (MLA) at the stented segment and minimum stent area (MSA). Major adverse cardiac events (MACE) including all-cause death, non-fatal myocardial infarction, and clinically driven revascularization were assessed. MACE-free survival rate was compared between patients with stent showing NA (NA group) and those without NA (non-NA group). Furthermore, in per-stent basis analysis, stent failure including remote revascularization and stent thrombosis of the stent after follow-up OCT examination was assessed.
Results
NA was identified in 50 stents (15.8%) in 38 patients (19.5%). During the median follow-up period of 2.1 [1.0- 2.8] years after OCT examination, 15 MACEs (7.7%) were captured in the total cohort, of which stent failure was observed in 5 stents (5/316, 1.6%). In patient-based analysis, patients with NA had more frequent MACE than those without (18.0% vs 5.1%, p=0.01). Kaplan-Meier analysis revealed that significantly higher MACE rate was detected in NA group than in non-NA group (χ2=5.4, Log-rank p=0.02). In stent-based analysis, NA stents had more frequent stent failure than those without (8.0% vs 0.4%, p=0.002)
Conclusions
NA observed by OCT at >3 years after implantation were associated with subsequent worse clinical outcomes in both patient and stent-based analysis. NA at the very late phase after stenting might be the therapeutic target of secondary prevention and OCT examination at very late phase after stenting may help identify high risk patients of subsequent MACE.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Tokyo, Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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28
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Kanaji Y, Sugiyama T, Hoshino M, Ueno H, Nogami K, Hada M, Misawa T, Sumino Y, Yamaguchi M, Yonetsu T, Kakuta T. Prognostic value of coronary flow capacity assessed by coronary sinus flow obtained by phase contrast cine-magnetic resonance imaging in patients with acute coronary syndrome. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1710] [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
The concept of coronary flow capacity (CFC) originated from positron emission tomography has been reported to provide prognostic information. Phase contrast cine-magnetic resonance imaging (PC-CMR) of the coronary sinus (CS) is a promising approach for quantifying global coronary sinus flow (CSF) and global coronary flow reserve (g-CFR) without the need for ionizing radiation, radioactive tracers, or intravascular catheterization.
Purpose
We evaluated the prognostic value of postprocedural CFC by quantifying CSF using PC-CMR in patients with acute coronary syndrome (ACS) treated with primary or urgent percutaneous coronary intervention (PCI).
Methods
This study prospectively but nonconsecutively enrolled 569 ACS patients who underwent uncomplicated primary (for ST-segment elevation myocardial infarction (STEMI)) or urgent PCI within 48 hours of symptom onset (for non-ST elevation acute coronary syndrome (NSTE-ACS)). Breath-hold PC-CMR images of CS were acquired to assess absolute CSF at rest and during maximum hyperemia within 30 days after culprit lesion PCI and revascularization of functionally significant non-culprit lesions. The entire cohort was stratified by the CFC according to the thresholds of hyperemic CSF and g-CFR. Impaired CFC was defined as a severely-reduced CFC in the present study. The association of CFC and baseline clinical characteristics with major adverse cardiac events (all-cause death, nonfatal myocardial infarction, hospitalization for congestive heart failure or stroke) was investigated.
Results
In the final analysis of 502 patients (Male 417 (83.1%), mean age was 67 [58, 73]) and 310 patients (82.3%) with STEMI and 192 patients (38.2%) with NSTE-ACS were studied. In a total cohort, rest and maximal hyperemic CSF and corrected G-CFR were 0.93 [0.68, 1.24] ml/min/g, 2.08 [1.44, 2.77] ml/min/g, and 2.21 [1.58, 3.05], respectively. During a median follow-up of 28 months, MACE occurred in 53 patients (all-cause death: 19, nonfatal myocardial infarction: 16, late revascularization: 59, hospitalization for congestive heart failure: 9, stroke: 9). Cox proportional hazards analysis showed that corrected G-CFR and impaired CFC were both independent predictors of MACE. (hazard ratio (HR), 0.61, 95% confidence interval (CI): 0.45–0.82, p=0.001; HR, 3.51, 95% CI: 1.79–6.86, p≤0.001, respectively). Cardiac event-free survival was significantly worse in patients with impaired CFC (log-rank χ2=22.9, P<0.001). Net reclassification index (NRI) and integrated discrimination improvement (IDI) were both significantly improved when impaired CFC was added to the clinical risk model for predicting MACE.
Conclusions
In ACS patients successfully revascularized with primary or urgent PCI, CFC categorization stratified by noninvasive PC-CMR provided significant prognostic information independent of infarction size, conventional risk factors and g-CFR.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Cardiovascular medicine, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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Yamaguchi M, Hoshino M, Nogami K, Ueno H, Misawa T, Sumino Y, Hada M, Kanaji Y, Sugiyama T, Yonetsu T, Kakuta T. Association between near-infrared spectroscopy defined lipid rich plaque and pericoronary adipose tissue inflammation on computed tomography angiography. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0314] [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
A recent study has shown that lipid-rich plaque (LRP) detected by near-infrared spectroscopy (NIRS) is a significant predictor of future adverse events. Pericoronary adipose tissue inflammation (FAI; fat attenuation index) evaluated by computed tomography angiography (CTA) has also been reported to be linked with cardiac events. The relationship between NIRS-defined LRP and FAI remains to be determined.
Methods
A total of 82 de novo culprit lesions in 82 patients with chronic coronary syndromes (CCS) who underwent perprocedural CTA and NIRS was retrospectively studied. FAI was assessed by the crude analysis of the mean CT attenuation value (−190 to −30 Hounsfield units; higher values indicating inflammation) of pericoronary adipose tissue. Plaque morphology was assessed by coronary CTA and grey-scale intravascular ultrasound (IVUS). NIRS-defined LRP was defined as a maximum lipid core burden index (LCBI) in 4 mm ≥400. Relationship between NIRS-defined LRP, CTA/grey-scale IVUS findings, and FAI was assessed. Univariate and multivariate logistic regression analyses were performed to determine the predictors for NIRS-derived LRP.
Results
NIRS-defined LRP was observed in 35 (42.6%) patients. Maximum LCBI showed modest correlations both with FAI (r=0.29, p-value=0.007) and CT-derived remodeling index (r=0.51, p<0.001). Receiver operating characteristic (ROC) curve analysis revealed that the best cut-off values of FAI and CT-derived remodeling index for predicting NIRS-defined LRP were −70.7 (AUC: 0.65, 95% CI: 0.53–0.71, P<0.05) and 1.11 (AUC: 0.74, 95% CI: 0.63–0.86, P<0.01), respectively. Multivariate logistic regression analysis showed FAI ≥−70.7 (odds ratio [OR]: 4.27; 95% CI: 1.28–14.3; p-value = 0.02) and CT-derived remodeling index (OR: 10.7; 95% CI: 2.99–32.2; p-value <0.001) were independent predictors of the presence of NIRS-defined LRP, whereas there was no statistically significant and independent predictor of IVUS-derived factors for NIRS-defined LRP. When stratified according to the presence or absence of FAI ≥−70.7 and CT-derived remodeling index ≥1.11, 93% of the lesions showed NIRS-derived LRP when both factors were present, and NIRS-derived LRP was safely ruled out (88%) when both factors were absent.
Conclusions
FAI of the culprit lesion in CCS was an independent predictor of NIRS-defined LRP, supporting the notion that local pericoronary adipose tissue inflammation may correlate to the presence of LRP. Comprehensive assessment of coronary CTA including FAI evaluation may provide a highly accurate information with high sensitivity and specificity for identifying high risk lesions potentially leading to future cardiac events.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Yamaguchi
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Kakuta
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
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Yamaguchi M, Hoshino M, Nogami K, Ueno H, Misawa T, Sumino Y, Hada M, Kanaji Y, Sugiyama T, Yonetsu T, Kakuta T. Clinical significance of the periaortic adipose tissue inflammation in patients with abdominal aortic aneurysms. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2331] [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
Recent studies have reported the association between periaortic adipose tissue volumes identified by multi-detector computed tomography (MDCT) and the periaortic adipose tissue inflammation (PATI) identified by positron emission tomography, which may suggest the link between perivascular inflammation and aortic dilation. However, clinical significance of the PATI identified by MDCT remains elusive in patients with asymptomatic abdominal aortic aneurysm (AAA).
Methods
A total of 77 patients with AAA (diameter >30mm) who underwent the initial and follow-up MDCT examinations were studied retrospectively. PATI was assessed by the crude analysis of the mean CT attenuation value (−190 to −30 Hounsfield units; higher values indicating inflammation). The AAA progression (AP) was defined as the growth of AAA diameter >5.0mm/year from the initial to follow-up. Univariate and multivariate logistic regression analysis were performed to determine the predictors for AP.
Results
AP was observed in 19 (24.7%) patient, the median initial AAA diameter was 38.9 (32.7–42.9) mm, and the median progression of AAA diameter was 3.1 (1.5–4.9) mm/year. The initial AAA diameter (odds ratio [OR]: 1.16; 95% confidence interval [CI]: 1.05–1.28; p-value=0.001) and the initial PATI (OR: 1.12; 95% CI: 1.05–1.20; p-value=0.004) were independent predictors of AP. PATI of −71.08 at initial MDCT and the initial AAA diameter of 37.7mm were the best cut-off value to predict AP. Receiver operating characteristic curve analysis revealed that the best cut-off values of PATI at initial MDCT and the initial AAA diameter for predicting AP were −71.08 (AUC: 0.68, 95% CI: 0.50–0.82) and 37.7 (AUC: 0.71, 95% CI: 0.59–0.84), respectively. Addition of the initial AAA diameter to PATI at initial MDCT significantly increased the accuracy for discriminating AP (net reclassification improvement; 95% CI: 0.67 [0.17–1.17]; p-value = 0.007, integrated discrimination improvement; 95% CI: 0.14 [0.04–0.24]; p-value =0.007).
Conclusions
PATI was an independent and significant predictor of aortic dilation, supporting the notion that local adipose tissue inflammation may contribute to aortic remodeling. Comprehensive assessment of MDCT including PATI evaluation may provide a highly accurate information for identifying high risk lesions potentially leading to future AAA rupture.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Yamaguchi
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - T Misawa
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo Hospital, Department of Cardiovascular Medicine, Tsuchiura, Japan
| | - T Yonetsu
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine, Tokyo, Japan
| | - T Kakuta
- Tokyo Medical and Dental University, Department of Cardiovascular Medicine, Tokyo, Japan
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Misawa T, Sugiyama T, Kanaji Y, Hoshino M, Yamaguchi M, Hada M, Sumino Y, Ueno H, Nogami K, Kakuta T. Impact of pericoronary inflammation assessed by coronary computed tomography angiography on the progression of aortic valve calcification. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1907] [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
Aortic valve calcification (AVC) has been known as an independent predictor for adverse cardiovascular events and all-cause mortality. Previous studies demonstrated that AVC was associated with aortic valve inflammation and atherosclerosis. However, the relationship between the progression of AVC and pericoronary inflammation remains undetermined.
Purpose
The purpose of this study was to evaluate the impact of the pericoronary inflammation on the progression of AVC.
Methods
A total of 107 patients with suspected or known chronic coronary syndromes who underwent clinically indicated serial 320-slice coronary computed tomography angiography (CTA) at Tsuchiura Kyodo General Hospital from January 2011 to June 2019 were retrospectively studied. Pericoronary inflammation was assessed by pericoronary adipose tissue attenuation (PCATA) defined as the mean CT attenuation value of PCATA (−190 to −30 Hounsfield units [HU]) on proximal 40 mm segments of coronary arteries. AVC was quantified by Agatston score on CTA. The mean aortic attenuation (HU Aorta) and the standard deviation (SD) in the region of interest at the level of the sinotubular junction was measured. AVC was defined as the threshold for calcium detection (mean HU Aorta + 2SD). AVC index was calculated as follows: (follow-up/baseline) AVC divided by follow-up period. AVC progression was defined as newly-developed AVC at follow-up or an increased AVC index during follow-up. All patients were divided into two groups according to the presence or absence of AVC progression, and clinical characteristics and CT findings were compared between these two groups.
Results
AVC progression was observed in 26 patients (24.3%) between 2 serial CT examinations (median, 34 months). There was no significant difference in age, gender and the prevalence of other cardiovascular risk factors between the 2 groups. Patients in AVC progression group were associated with higher prevalence of elevated PCATA-LAD, higher LV mass index at baseline and the initial AVC presence. Receiver-operating characteristic curve analysis revealed that the optimal cut off value of PCATA-LAD for predicting AVC progression was −68.26 HU (area under the curve 0.605; 95% confidence interval [CI], 0.465–0.745). Multivariable logistic regression analysis revealed that baseline PCATA-LAD ≥−68.26 HU (odds ratio [OR], 3.12; 95% CI, 1.04–9.35, p=0.042) and the presence of baseline positive AVC (OR, 6.84; 95% CI, 2.34–20.0, p=0.0004) were independent predictors of AVC progression.
Conclusions
The increased pericoronary inflammation and the presence of AVC may help identify patients with high risk for future AVC progression.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- T Misawa
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Sugiyama
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Kanaji
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hoshino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Yamaguchi
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - M Hada
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - Y Sumino
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - H Ueno
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - K Nogami
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
| | - T Kakuta
- Tsuchiura Kyodo General Hospital, Tsuchiura, Japan
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Kurashige T, Morino H, Ueno H, Murao T, Watanabe T, Hinoi T, Nishino I, Maruyama H, Torii T. FSHD / OPMD / MYOTONIC DYSTROPHY. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Nagata K, Shinto E, Yamadera M, Shiraishi T, Kajiwara Y, Okamoto K, Mochizuki S, Hase K, Kishi Y, Ueno H. Prognostic and predictive values of tumour budding in stage IV colorectal cancer. BJS Open 2020; 4:693-703. [PMID: 32472647 PMCID: PMC7397347 DOI: 10.1002/bjs5.50300] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/22/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Tumour budding is an important prognostic feature in early-stage colorectal cancer, but its prognostic significance in metastatic disease has not been fully investigated. METHODS Patients with stage IV disease who had primary colorectal tumour resection without previous chemotherapy or radiotherapy from January 2000 to December 2018 were reviewed retrospectively. Budding was evaluated at the primary site and graded according to the criteria of the International Tumor Budding Consensus Conference (ITBCC) (BD1, low; BD2, intermediate; BD3, high). Patients were categorized by metastatic (M1a, M1b) and resectional (R0/R1, R2/unresected) status. Subgroups were compared for overall (OS) and recurrence-free (RFS) survival in R0/R1 subgroups; R2/unresected patients were evaluated for the rate of tumour progression, based on change in tumour size from baseline. RESULTS Of 371 patients observed during the study, 362 were analysed. Patients with BD3 had a lower 5-year OS rate than those with BD1 + BD2 (18·4 versus 40·5 per cent; P < 0·001). Survival analyses according to metastatic and resection status also showed that BD3 was associated with shorter OS than BD1 + BD2. In multivariable analysis, BD3 (hazard ratio (HR) 1·51, 95 per cent c.i. 1·11 to 2·10; P = 0·009), T4 status (HR 1·39) and R2/unresected status (HR 3·50) were associated with decreased OS. In the R0/R1 subgroup, the 2-year RFS rate was similar for BD3 and BD1 + BD2 according to metastatic status. There was no significant difference between BD3 and BD1 + BD2 for change in tumour size in the R2/unresected subgroup (P = 0·094). Of 141 patients with initially unresectable metastases who had chemotherapy, 35 achieved conversion from unresectable to resectable status. The conversion rate was significantly higher for BD1 + BD2 than for BD3 (36 versus 18 per cent; P = 0·016). CONCLUSION Stage IV colorectal cancer with high-grade tumour budding according to ITBCC criteria correlates with poor prognosis.
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Affiliation(s)
- K. Nagata
- Department of SurgeryNational Defence Medical College3‐2 NamikiTokorozawa359‐8513Japan
| | - E. Shinto
- Department of SurgeryNational Defence Medical College3‐2 NamikiTokorozawa359‐8513Japan
| | - M. Yamadera
- Department of SurgeryNational Defence Medical College3‐2 NamikiTokorozawa359‐8513Japan
| | - T. Shiraishi
- Department of SurgeryNational Defence Medical College3‐2 NamikiTokorozawa359‐8513Japan
| | - Y. Kajiwara
- Department of SurgeryNational Defence Medical College3‐2 NamikiTokorozawa359‐8513Japan
| | - K. Okamoto
- Department of SurgeryNational Defence Medical College3‐2 NamikiTokorozawa359‐8513Japan
| | - S. Mochizuki
- Department of SurgeryNational Defence Medical College3‐2 NamikiTokorozawa359‐8513Japan
| | - K. Hase
- Department of SurgeryNational Defence Medical College3‐2 NamikiTokorozawa359‐8513Japan
| | - Y. Kishi
- Department of SurgeryNational Defence Medical College3‐2 NamikiTokorozawa359‐8513Japan
| | - H. Ueno
- Department of SurgeryNational Defence Medical College3‐2 NamikiTokorozawa359‐8513Japan
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Boulay F, Simpson GS, Ichikawa Y, Kisyov S, Bucurescu D, Takamine A, Ahn DS, Asahi K, Baba H, Balabanski DL, Egami T, Fujita T, Fukuda N, Funayama C, Furukawa T, Georgiev G, Gladkov A, Hass M, Imamura K, Inabe N, Ishibashi Y, Kawaguchi T, Kawamura T, Kim W, Kobayashi Y, Kojima S, Kusoglu A, Lozeva R, Momiyama S, Mukul I, Niikura M, Nishibata H, Nishizaka T, Odahara A, Ohtomo Y, Ralet D, Sato T, Shimizu Y, Sumikama T, Suzuki H, Takeda H, Tao LC, Togano Y, Tominaga D, Ueno H, Yamazaki H, Yang XF, Daugas JM. g Factor of the ^{99}Zr (7/2^{+}) Isomer: Monopole Evolution in the Shape-Coexisting Region. Phys Rev Lett 2020; 124:112501. [PMID: 32242689 DOI: 10.1103/physrevlett.124.112501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/28/2019] [Accepted: 12/17/2019] [Indexed: 06/11/2023]
Abstract
The gyromagnetic factor of the low-lying E=251.96(9) keV isomeric state of the nucleus ^{99}Zr was measured using the time-dependent perturbed angular distribution technique. This level is assigned a spin and parity of J^{π}=7/2^{+}, with a half-life of T_{1/2}=336(5) ns. The isomer was produced and spin aligned via the abrasion-fission of a ^{238}U primary beam at RIKEN RIBF. A magnetic moment |μ|=2.31(14)μ_{N} was deduced showing that this isomer is not single particle in nature. A comparison of the experimental values with interacting boson-fermion model IBFM-1 results shows that this state is strongly mixed with a main νd_{5/2} composition. Furthermore, it was found that monopole single-particle evolution changes significantly with the appearance of collective modes, likely due to type-II shell evolution.
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Affiliation(s)
- F Boulay
- CEA, DAM, DIF, 91297 Arpajon cedex, France
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- GANIL, CEA/DSM-CNRS/IN2P3, BP55027, 14076 Caen cedex 5, France
| | - G S Simpson
- LPSC, CNRS/IN2P3, Université Joseph Fourier Grenoble 1, INPG, 38026 Grenoble Cedex, France
| | - Y Ichikawa
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - S Kisyov
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 077125 Bucharest-Măgurele, Romania
| | - D Bucurescu
- Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 077125 Bucharest-Măgurele, Romania
| | - A Takamine
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D S Ahn
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Asahi
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - H Baba
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D L Balabanski
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Extreme Light Infrastructure-Nuclear Physics (ELI-NP), Horia Hulubei National Institute for R&D in Physics and Nuclear Engineering (IFIN-HH), 077125 Bucharest-Măgurele, Romania
| | - T Egami
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Advanced Sciences, Hosei University, 3-7-2 Kajino-cho, Koganei, Tokyo 184-8584, Japan
| | - T Fujita
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Osaka University, Machikaneyama 1-1 Toyonaka, Osaka 560-0034, Japan
| | - N Fukuda
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - C Funayama
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - T Furukawa
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Metropolitan University, 1-1 Minami-Ohsawa, Hachioji, Tokyo 192-0397, Japan
| | - G Georgiev
- CSNSM, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay Campus, France
| | - A Gladkov
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu 702-701, South Korea
| | - M Hass
- Department of Particle Physics, Weizmann Institute of Science, Rehovot 76100, Israel
| | - K Imamura
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Meiji University, 1-1-1 Higashi-Mita, Tama, Kawasaki, Kanagawa 214-8571, Japan
| | - N Inabe
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Y Ishibashi
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki 305-5877, Japan
| | - T Kawaguchi
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Advanced Sciences, Hosei University, 3-7-2 Kajino-cho, Koganei, Tokyo 184-8584, Japan
| | - T Kawamura
- Department of Physics, Osaka University, Machikaneyama 1-1 Toyonaka, Osaka 560-0034, Japan
| | - W Kim
- Department of Physics, Kyungpook National University, 80 Daehak-ro, Buk-gu, Daegu 702-701, South Korea
| | - Y Kobayashi
- Department of Informatics and Engineering, University of Electro-Communication, 1-5-1 Chofugaoka, Chohu, Tokyo 182-8585, Japan
| | - S Kojima
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - A Kusoglu
- CSNSM, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay Campus, France
- Department of Physics, Faculty of Science, Istanbul University, Vezneciler/Faith, 34134 Istanbul, Turkey
| | - R Lozeva
- CSNSM, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay Campus, France
| | - S Momiyama
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - I Mukul
- Department of Particle Physics, Weizmann Institute of Science, Rehovot 76100, Israel
| | - M Niikura
- Department of Physics, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-0033, Japan
| | - H Nishibata
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Osaka University, Machikaneyama 1-1 Toyonaka, Osaka 560-0034, Japan
| | - T Nishizaka
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Advanced Sciences, Hosei University, 3-7-2 Kajino-cho, Koganei, Tokyo 184-8584, Japan
| | - A Odahara
- Department of Physics, Osaka University, Machikaneyama 1-1 Toyonaka, Osaka 560-0034, Japan
| | - Y Ohtomo
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - D Ralet
- CSNSM, Université Paris-Sud, CNRS/IN2P3, Université Paris-Saclay, 91405 Orsay Campus, France
| | - T Sato
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - Y Shimizu
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Sumikama
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Suzuki
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Takeda
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - L C Tao
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- State Key Laboratory of Nuclear Physics and Technology, School of Physics, Peking University, Beijing 100871, China
| | - Y Togano
- Department of Physics, Tokyo Institute of Technology, 2-12-1 Oh-okayama, Meguro, Tokyo 152-8551, Japan
| | - D Tominaga
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Department of Advanced Sciences, Hosei University, 3-7-2 Kajino-cho, Koganei, Tokyo 184-8584, Japan
| | - H Ueno
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Yamazaki
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - X F Yang
- Instituut voor Kern- en Stralingsfysica, K.U. Leuven, Celestijnenlaan 200D, 3001 Leuven, Belgium
| | - J M Daugas
- CEA, DAM, DIF, 91297 Arpajon cedex, France
- RIKEN Nishina Center for Accelerator-Based Science, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
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Shinto E, Omata J, Sikina A, Sekizawa A, Kajiwara Y, Hayashi K, Hashiguchi Y, Hase K, Ueno H. Predictive immunohistochemical features for tumour response to chemoradiotherapy in rectal cancer. BJS Open 2020; 4:301-309. [PMID: 32026629 PMCID: PMC7093790 DOI: 10.1002/bjs5.50251] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 11/21/2019] [Indexed: 01/02/2023] Open
Abstract
Background Reduced expression of cluster of differentiation (CD) 133 and cyclo‐oxygenase (COX) 2, and increased density of CD8+ tumour‐infiltrating lymphocytes, are associated with a favourable tumour response to preoperative chemoradiotherapy (CRT). This study aimed to evaluate these markers in relation to tumour response after preoperative CRT in two rectal cancer cohorts. Methods Patients with low rectal cancer who underwent radical resection and preoperative short‐term CRT in 2001–2007 (retrospective cohort) and long‐term CRT in 2011–2017 (prospective cohort) were analysed. Pretreatment biopsies were stained immunohistochemically using antibodies to determine CD133 and COX‐2 expression, and increased CD8+ density. Outcome measures were tumour regression grade (TRG), tumour downstaging and survival. Results For 95 patients in the retrospective cohort, the incidence of TRG 3–4 was 67 per cent when two or three immunohistochemistry (IHC) features were present, but only 20 per cent when there were fewer features (P < 0·001). The incidence of tumour downstaging was higher in patients with at least two IHC features (43 versus 22 per cent with fewer features; P = 0·029). The 49 patients in the prospective cohort had similar rates to those in the retrospective cohort (TRG 3–4: 76 per cent for two or more IHC features versus 25 per cent with fewer features, P < 0·001; tumour downstaging: 57 versus 25 per cent respectively, P = 0·022). Local recurrence‐free survival rates in patients with more or fewer IHC features were similar in the retrospective and prospective cohort (P = 0·058 and P = 0·387 respectively). Conclusion Assessment of CD133, COX‐2 and CD8 could be useful in predicting a good response to preoperative CRT in patients with lower rectal cancer undergoing neoadjuvant therapy. Further studies are needed to validate the results in larger cohorts and investigate a survival benefit.
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Affiliation(s)
- E Shinto
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - J Omata
- Department of Surgery, Self-Defense Forces Central Hospital, Tokyo, Japan
| | - A Sikina
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - A Sekizawa
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - Y Kajiwara
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - K Hayashi
- Department of Radiology, National Defense Medical College, Tokorozawa, Japan
| | - Y Hashiguchi
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - K Hase
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
| | - H Ueno
- Department of Surgery, National Defense Medical College, Tokorozawa, Japan
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Kotruchin P, Hoshide S, Ueno H, Komori T, Kario K. P254 The differential impact of renal resistive index on future cardiovascular event in the hospitalised cardiovascular patients according to left ventricular ejection fraction: J-VAS study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehz872.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Renal resistive index (RRI) not only reflects renal vascular hemodynamics but also correlates well with systemic arterial stiffness. RRI associated with cardiovascular events in the selected group of cardiovascular patients including heart failure (HF). However, previous study limited only in the preserved ejection fraction (EF) patients.
Purpose
To determine the differential impact of RRI on cardiovascular events among cardiovascular patients according to EF.
Methods
A retrospective analysis of the Jichi Vascular Hemodynamics in Hospitalised Cardiovascular Patients (J-VAS) cohort. EF and RRI were measured in all patients, then categorised into groups of reduced EF (rEF < 40%), mid-range EF (mrEF 41-49%), and preserved EF (pEF≥50%). The latter group was subdivided into RRI≥0.8 and <0.8 to identify the risk of the primary endpoint, which was the composite of cardiac death, HF, acute coronary syndrome (ACS), aortic disease, arterial occlusion, and stroke.
Results
We included 1765 patients (mean age 64.7 years, 76% men). The most common diagnoses were ACS(66%) and HF(25%). During the median follow up of 1.9 years, 252 cardiovascular events occurred, 30.7%, 17.7%, and 10.4% in the rEF, mrEF and pEF group. RRI≥0.8 associated with the primary endpoint in the patients with pEF (Hazard ratio(HR), 1.69; 95%confident interval(CI) 1.11-2.58), but the association was not found in the other EF groups. Multivariate Cox regression analysis putting the pEF with RRI < 0.8 as a reference, pEF with RRI≥0.8 had a comparable risk for the primary endpoint to the mrEF group (HR, 1.55; 95%CI, 1.04-2.30 and HR, 1.92; 95%CI, 1.31-2.80, respectively), while the risk was highest in the rEF group (HR, 3.80; 95%CI, 2.73-5.29).
Conclusions
The risk of cardiovascular events in cardiovascular patients with pEF related to renal vascular hemodynamic alterations justified by RRI. In the patients with pEF, those with high RRI had comparable risk to the mrEF patients.
Risk of RRI≥0.8 for the primary endpoint Preserved EF HR (95%CI); P Mid-range EF HR (95%CI); P Reduced EF HR (95%CI); P Model 1 2.05 (1.39-3.02); P <0.001 1.60 (0.81-3.18); P =0.179 0.94 (0.53-1.67); P =0.838 Model 2 1.86 (1.25-2.78); P =0.002 1.33 (0.65-2.72); P =0.430 0.93 (0.52-1.66); P =0.792 Model 3 1.69 (1.11-2.58); P =0.015 1.10 (0.51-2.36); P =0.810 0.70 (0.38-1.28); P =0.242 Adjusted hazard ratio of RRI≥0.8 for the primary endpoint, RRI≥0.8 associated with a significant risk for the primary endpoint in the pEF group but not in the mrEF and rEF group. Model 1 was adjusted for age, sex and body mass index (BMI). Model 2 was adjusted for age, sex, BMI, smoking, dyslipidemia, and diabetes. Model 3 was adjusted for age, sex, BMI, smoking, dyslipidemia, diabetes, and glomerular filtration rate (GFR).
Abstract P254 Figure. Survival plot of the 4 subgroups
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Affiliation(s)
- P Kotruchin
- Khon Kaen University, Emergency Medicine, Khon Kaen, Thailand
| | - S Hoshide
- Jichi Medical University, Cardiovascular Medicine, Tochigi, Japan
| | - H Ueno
- Jichi Medical University, Cardiovascular Medicine, Tochigi, Japan
| | - T Komori
- Jichi Medical University, Cardiovascular Medicine, Tochigi, Japan
| | - K Kario
- Jichi Medical University, Cardiovascular Medicine, Tochigi, Japan
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Ahn DS, Fukuda N, Geissel H, Inabe N, Iwasa N, Kubo T, Kusaka K, Morrissey DJ, Murai D, Nakamura T, Ohtake M, Otsu H, Sato H, Sherrill BM, Shimizu Y, Suzuki H, Takeda H, Tarasov OB, Ueno H, Yanagisawa Y, Yoshida K. Location of the Neutron Dripline at Fluorine and Neon. Phys Rev Lett 2019; 123:212501. [PMID: 31809143 DOI: 10.1103/physrevlett.123.212501] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Indexed: 06/10/2023]
Abstract
A search for the heaviest isotopes of fluorine, neon, and sodium was conducted by fragmentation of an intense ^{48}Ca beam at 345 MeV/nucleon with a 20-mm-thick beryllium target and identification of isotopes in the large-acceptance separator BigRIPS at the RIKEN Radioactive Isotope Beam Factory. No events were observed for ^{32,33}F, ^{35,36}Ne, and ^{38}Na and only one event for ^{39}Na after extensive running. Comparison with predicted yields excludes the existence of bound states of these unobserved isotopes with high confidence levels. The present work indicates that ^{31}F and ^{34}Ne are the heaviest bound isotopes of fluorine and neon, respectively. The neutron dripline has thus been experimentally confirmed up to neon for the first time since ^{24}O was confirmed to be the dripline nucleus nearly 20 years ago. These data provide new keys to understanding the nuclear stability at extremely neutron-rich conditions.
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Affiliation(s)
- D S Ahn
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - N Fukuda
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Geissel
- GSI, Helmholtzzentrum für Schwerionenforschung GmbH, Planckstraße 1, 64291 Darmstadt, Germany
| | - N Inabe
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - N Iwasa
- Department of Physics, Tohoku University, 6-3, Aramaki Aza-Aoba, Aoba-ku, Sendai, Miyagi 980-8578, Japan
| | - T Kubo
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Kusaka
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D J Morrissey
- National Superconducting Cyclotron Laboratory, Michigan State University, 640 South Shaw Lane, East Lansing, Michigan 48824, USA
| | - D Murai
- Department of Physics, Rikkyo University, 3-34-1 Nishi-Ikebukuro, Toshima, Tokyo 171-8501, Japan
| | - T Nakamura
- Department of Physics, Tokyo Institute of Technology, 2-12-1 O-Okayama, Meguro, Tokyo 152-8551, Japan
| | - M Ohtake
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Otsu
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Sato
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - B M Sherrill
- National Superconducting Cyclotron Laboratory, Michigan State University, 640 South Shaw Lane, East Lansing, Michigan 48824, USA
| | - Y Shimizu
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Suzuki
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Takeda
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - O B Tarasov
- National Superconducting Cyclotron Laboratory, Michigan State University, 640 South Shaw Lane, East Lansing, Michigan 48824, USA
| | - H Ueno
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Y Yanagisawa
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Yoshida
- RIKEN Nishina Center for Accelerator-Based Science, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
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Kanemitsu Y, Shida D, Tsukamoto S, Ueno H, Ishiguro M, Ishihara S, Komori K, Sugihara K. Nomograms predicting survival and recurrence in colonic cancer in the era of complete mesocolic excision. BJS Open 2019; 3:539-548. [PMID: 31388647 PMCID: PMC6677094 DOI: 10.1002/bjs5.50167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 02/27/2019] [Indexed: 01/07/2023] Open
Abstract
Background More extensive lymphadenectomy may improve survival after resection of colonic cancer. Nomograms were created predicting overall survival and recurrence for patients who undergo D2-D3 lymph node dissection, and their validity determined. Methods This was a multicentre study of patients with colonic cancer who underwent resection with D2-D3 lymph node dissection in Japan. Inclusion criteria included R0 resection. A training cohort of patients operated on from 2007 to 2008 was analysed to construct prognostic models predicting survival and recurrence. Discrimination and calibration were performed using an external validation cohort from the Japanese colorectal cancer registry (procedures in 2005-2006). Results The training cohort consisted of 2746 patients. Predictors of survival were: age (hazard ratio (HR) 1·04), female sex (HR 0·71), depth of tumour invasion (HR 1·15, 1·22, 2·96 and 3·14 for T2, T3, T4a and T4b respectively versus T1), lymphatic invasion (HR 1·11, 1·15 and 2·95 for ly1, ly2 and ly3 versus ly0), preoperative carcinoembryonic antigen (CEA) level (HR 1·21, 1·59 and 1·99 for 5·1-10·0, 10·1-20·0 and 20·1 and over versus 0-5·0 ng/ml), number of metastatic lymph nodes (HR 1·07), number of lymph nodes examined (HR 0·98) and extent of lymphadenectomy (HR 0·23, 0·13 and 0·11 for D1, D2 and D3 versus D0). Predictors of recurrence were: female sex (HR 0·82), macroscopic type (HR 3·82, 4·56, 6·66, 7·74 and 3·22 for types I, II, III, IV and V versus type 0), depth of invasion (HR 1·25, 2·66, 5·32 and 6·43 for T2, T3, T4a and T4b versus T1), venous invasion (HR 1·43, 3·05 and 4·79 for v1, v2 and v3 versus v0), preoperative CEA level (HR 1·39, 1·43, 1·56 and 1·85 for 5·1-10·0, 10·1-20·0, 20·1-40·0 and 40·1 or more versus 0-5 ng/ml), number of metastatic lymph nodes (HR 1·07) and number of lymph nodes examined (HR 0·98). The validation cohort comprised 4446 patients. The internal and external validated Harrell's C-index values for the nomogram predicting survival were 0·75 and 0·74 respectively. Corresponding values for recurrence were 0·78 and 0·75. Conclusion These nomograms could predict survival and recurrence after curative resection of colonic cancer.
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Affiliation(s)
- Y. Kanemitsu
- Department of Colorectal SurgeryNational Cancer Centre HospitalSaitamaJapan
| | - D. Shida
- Department of Colorectal SurgeryNational Cancer Centre HospitalSaitamaJapan
| | - S. Tsukamoto
- Department of Colorectal SurgeryNational Cancer Centre HospitalSaitamaJapan
| | - H. Ueno
- Department of SurgeryNational Defense Medical CollegeSaitamaJapan
| | - M. Ishiguro
- Department of Translational Oncology andGraduate School, Tokyo Medical and Dental UniversitySaitamaJapan
| | - S. Ishihara
- Department of Surgical Oncology, School of MedicineThe University of TokyoSaitamaJapan
| | - K. Komori
- Department of Gastroenterological SurgeryAichi Cancer CentreNagoyaJapan
| | - K. Sugihara
- Department of Surgical OncologyGraduate School, Tokyo Medical and Dental UniversitySaitamaJapan
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Watanabe J, Sato T, Kagawa Y, Oki E, Kuboki Y, Ikeda M, Ueno H, Kato T, Kusumoto T, Masuishi T, Yamaguchi K, Kanazawa A, Nishina T, Uetake H, Yamanaka T, Yoshino T. SUNRISE-DI study: decision impact of the 12-gene recurrence score (12-RS) assay on adjuvant chemotherapy recommendation for stage II and IIIA/B colon cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz154.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Ishikawa T, Ishiguro M, Nakatani E, Ueno H, Uetake H, Murotani K, Matsui S, Tomita N, Shimada Y, Takahashi K, Kotake K, Watanabe M, Mochizuki H, Teramukai S, Sugihara K. Prognostic impact of MSI and 18qLOH in stage II colon cancer: A prospective biomarker study in the SACURA trial. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.067] [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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Tarasov OB, Ahn DS, Bazin D, Fukuda N, Gade A, Hausmann M, Inabe N, Ishikawa S, Iwasa N, Kawata K, Komatsubara T, Kubo T, Kusaka K, Morrissey DJ, Ohtake M, Otsu H, Portillo M, Sakakibara T, Sakurai H, Sato H, Sherrill BM, Shimizu Y, Stolz A, Sumikama T, Suzuki H, Takeda H, Thoennessen M, Ueno H, Yanagisawa Y, Yoshida K. Discovery of ^{60}Ca and Implications For the Stability of ^{70}Ca. Phys Rev Lett 2018; 121:022501. [PMID: 30085743 DOI: 10.1103/physrevlett.121.022501] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/11/2018] [Indexed: 06/08/2023]
Abstract
The discovery of the important neutron-rich nucleus _{20}^{60}Ca_{40} and seven others near the limits of nuclear stability is reported from the fragmentation of a 345 MeV/u ^{70}Zn projectile beam on ^{9}Be targets at the radioactive ion-beam factory of the RIKEN Nishina Center. The produced fragments were analyzed and unambiguously identified using the BigRIPS two-stage in-flight separator. The eight new neutron-rich nuclei discovered, ^{47}P, ^{49}S, ^{52}Cl, ^{54}Ar, ^{57}K, ^{59,60}Ca, and ^{62}Sc, are the most neutron-rich isotopes of the respective elements. In addition, one event consistent with ^{59}K was registered. The results are compared with the drip lines predicted by a variety of mass models and it is found that the models in best agreement with the observed limits of existence in the explored region tend to predict the even-mass Ca isotopes to be bound out to at least ^{70}Ca.
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Affiliation(s)
- O B Tarasov
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
- Flerov Laboratory of Nuclear Reactions, JINR, 141980 Dubna, Moscow Region, Russian Federation
| | - D S Ahn
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D Bazin
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - N Fukuda
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - A Gade
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Hausmann
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - N Inabe
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - S Ishikawa
- Department of Physics, Tohoku University, 6-3 Aramaki-aza-aoba, Aoba, Sendai 980-8578, Japan
| | - N Iwasa
- Department of Physics, Tohoku University, 6-3 Aramaki-aza-aoba, Aoba, Sendai 980-8578, Japan
| | - K Kawata
- Center for Nuclear Study, University of Tokyo, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Komatsubara
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - T Kubo
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - K Kusaka
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - D J Morrissey
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Chemistry, Michigan State University, East Lansing, Michigan 48824, USA
| | - M Ohtake
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Otsu
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - M Portillo
- Facility for Rare Isotope Beams, Michigan State University, East Lansing, Michigan 48824, USA
| | - T Sakakibara
- Department of Physics, Tohoku University, 6-3 Aramaki-aza-aoba, Aoba, Sendai 980-8578, Japan
| | - H Sakurai
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Sato
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - B M Sherrill
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - Y Shimizu
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - A Stolz
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
| | - T Sumikama
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Suzuki
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - H Takeda
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - M Thoennessen
- National Superconducting Cyclotron Laboratory, Michigan State University, East Lansing, Michigan 48824, USA
- Department of Physics and Astronomy, Michigan State University, East Lansing, Michigan 48824, USA
| | - H Ueno
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - Y Yanagisawa
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
| | - K Yoshida
- RIKEN Nishina Center, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198, Japan
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Ueno H, Suga T, Miyake Y, Takao K, Tanaka T, Misaki J, Otsuka M, Nagano A, Isaka T. Specific adaptations of patellar and Achilles tendons in male sprinters and endurance runners. Transl Sports Med 2018. [DOI: 10.1002/tsm2.21] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- H. Ueno
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - T. Suga
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - Y. Miyake
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - K. Takao
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - T. Tanaka
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - J. Misaki
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - M. Otsuka
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - A. Nagano
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
| | - T. Isaka
- Faculty of Sport and Health Science; Ritsumeikan University; Kusatsu Japan
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Ueno H, Satake S. P900Incidence of silent cerebral embolism during HotBalloon ablation. Europace 2018. [DOI: 10.1093/europace/euy015.501] [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)
- H Ueno
- Hayama Heart Center, Hayama, Japan
| | - S Satake
- Hayama Heart Center, Hayama, Japan
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Morizane C, Ohno I, Ueno H, Mitsunaga S, Hashimoto Y, Okusaka T, Kondo S, Sasaki M, Sakamoto Y, Takahashi H, Hara R, Kobayashi S, Nakamura O, Ikeda M. Phase I study of resminostat/S-1 combination in patients with pre-treated biliary tract or pancreatic cancer. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.130] [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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Ohashi K, Iizumi S, Kuchiba A, Ikeda M, Sakamoto Y, Kondo S, Morizane C, Ueno H, Osame K, Mitsunaga S, Ohno I, Imaoka H, Hashimoto Y, Takahashi H, Sasaki M, Okusaka T. Impact of the duration of diabetes mellitus (DM) on the outcomes of metastatic pancreatic cancer (mPC) treated with gemcitabine (G): A retrospective study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Sasaki M, Ueno H, Omae K, Goto T, Murohisa G, Mizuno N, Ozaka M, Kobayashi S, Uesugi K, Kobayashi N, Hayashi H, Sudo K, Okano N, Horita Y, Kamei K, Hosokawa T, Henmi T, Kobayashi M, Todaka A, Fukutomi A. Risk factors for febrile neutropenia (FN) in unresectable/recurrent pancreatic cancer(PC) patients(pts) receiving FOLFIRINOX (FFX) from JASPAC06 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Shirasu H, Omae K, Fujii H, Mizuno N, Ozaka M, Ueno H, Kobayashi S, Uesugi K, Kobayashi N, Hayashi H, Sudo K, Okano N, Horita Y, Kamei K, Seigo Y, Takafumi H, Henmi T, Kobayashi M, Todaka A, Fukutomi A. The impact of UGT1A1 genetic polymorphism on safety in unresectable pancreatic cancer patients receiving FOLFIRINOX therapy: A subset analysis of JASPAC 06 study. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Okusaka T, Miyakawa H, Fujii H, Nakamori S, Satoh T, Hamamoto Y, Ito T, Maguchi H, Matsumoto S, Ueno H, Ioka T, Boku N, Egawa S, Hatori T, Furuse J, Mizumoto K, Ohkawa S, Yamaguchi T, Yamao K, Funakoshi A, Chen JS, Cheng AL, Sato A, Ohashi Y, Tanaka M. Updated results from GEST study: a randomized, three-arm phase III study for advanced pancreatic cancer. J Cancer Res Clin Oncol 2017; 143:1053-1059. [PMID: 28210843 PMCID: PMC5427167 DOI: 10.1007/s00432-017-2349-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 01/24/2017] [Indexed: 01/05/2023]
Abstract
PURPOSE The GEST study showed non-inferiority of S-1 but not superiority of gemcitabine plus S-1 (GS) to gemcitabine alone for overall survival with the data by the cut-off date of 31st July in 2010 for chemo-naïve patients with advanced pancreatic cancer. We considered it important to determine whether S-1 maintains non-inferiority after a long-term follow-up in the GEST study and to obtain a firm positive conclusion. In addition, it may be an interesting challenge to explore the efficacious profile of GS in the long-term follow-up study. Using the data from the follow-up period, background and efficacy in patients from Taiwan and Japan, as well as the rates of tumor shrinkage in locally advanced and metastatic patients (Waterfall plot) were also analyzed. METHODS The results of the primary analysis were reconfirmed, and subset analysis of overall survival and progression-free survival was performed based on the overall survival data updated by the cut-off date of 31st July in 2011. RESULTS The median follow-up period was 29.8 months, and 795 deaths occurred (95.6%). The median overall survival was 8.8 months for gemcitabine, 9.7 months for S-1 (hazard ratio [HR], 0.96; 97.5% confidence interval [CI], 0.79-1.17), and 9.9 months for GS (HR 0.91; 97.5% CI 0.75-1.11). In patients with performance status (PS) 0, the median overall survival was 9.8 months for gemcitabine, 10.9 months for S-1, and 10.5 months for GS. In patients with PS 1, the median overall survival was 6.2 months for gemcitabine, 6.3 months for S-1, and 9.6 months for GS. CONCLUSION Our survey reconfirmed the non-inferiority of S-1 to gemcitabine and showed S-1 can be used as one of the standard treatment options for advanced pancreatic cancer. TRIAL REGISTRATION ClinicalTrials.gov: NCT00498225.
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Affiliation(s)
- Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan.
| | - H Miyakawa
- Division of Biliopancreatology, Sapporo Kosei General Hospital, Sapporo, Japan
| | - H Fujii
- Division of Clinical Oncology, Jichi Medical University, Tochigi, Japan
| | - S Nakamori
- Hepato-Biliary-Pancreatic Surgery, Osaka National Hospital, Osaka, Japan
| | - T Satoh
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Japan
| | - Y Hamamoto
- Keio Cancer Center, Keio University Hospital, Tokyo, Japan
| | - T Ito
- Department of Medicine and Bioreguratory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - H Maguchi
- Center for Gastroenterology, Teine-Keijinkai Hospital, Sapporo, Japan
| | - S Matsumoto
- Department of Medical Oncology, Kyoto University Hospital, Kyoto, Japan
| | - H Ueno
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - T Ioka
- Department of Hepatobiliary and Pancreatic Oncology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan
| | - N Boku
- Gastrointestinal Medical Oncology Division, National Cancer Center Hospital, Tokyo, Japan
| | - S Egawa
- Department of Surgery, Tohoku University, Sendai, Japan
| | - T Hatori
- Department of Surgery and Digestive Diseases Center, International University of Health and Welfare Mita Hospital, Tokyo, Japan
| | - J Furuse
- Department of Medical Oncology, Kyorin University School of Medicine, Tokyo, Japan
| | - K Mizumoto
- Kyushu University Hospital Cancer Center, Fukuoka, Japan
| | - S Ohkawa
- Division of Hepatobiliary and Pancreatic Oncology, Kanagawa Cancer Center, Yokohama, Japan
| | - T Yamaguchi
- Department of Gastroenterology, Chiba Cancer Center, Chiba, Japan
| | - K Yamao
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - A Funakoshi
- Division of Pancreatology, Fukuoka Sanno Hospital, Fukuoka, Japan
| | - J S Chen
- Division of Hematology-Oncology, Linkou Chang Gung Memorial Hospital and Chang Gung University, Tao-Yuan, Taiwan, Republic of China
| | - A L Cheng
- Department of Oncology, National Taiwan University Hospital, and National Taiwan University Cancer Center, Taipei, Taiwan, Republic of China
| | - A Sato
- Department of Medical Oncology, Hirosaki University Graduate School of Medicine, Aomori, Japan
| | - Y Ohashi
- Department of Integrated Science and Engineering for Sustainable Society, Chuo University, Tokyo, Japan
| | - M Tanaka
- Department of Surgery, Shimonoseki City Hospital, Shimonoseki, Japan
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Nakashima T, Ohashi Y, Oki S, Saito R, Koido K, Ogawa C, Sato N, Seto K, Negishi Y, Kondo N, Kikuchi M, Yokoyama A, Ueno H, Koinuma M, Yachi Y, Terakado H. 349P A retrospective multicenter survey of hepatitis B virus infection (HBV) screening and HBV-DNA monitoring in patients receiving hematopoietic stem cell transplantation and rituximab-based chemotherapy. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00507-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Doi T, Yoh K, Shitara K, Takahashi H, Ueno M, Ohkawa S, Morimoto M, Kobayashi S, Okusaka T, Ueno H, Morizane C, Shiba S, Furuse J, Nagashima F, Naruge D, Okano N. First-in-man phase 1 study of TAS-114 in combination with S-1 in Japanese patients with advanced solid tumors. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)32956-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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